Skip to main content
SpringerLink
Log in

The effect of tear size on the treatment outcome of operatively treated rotator cuff tears

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to evaluate the relationship between the tear size and the short-term clinical outcome of rotator cuff reconstruction. The hypothesis was that the size of the rotator cuff tear has a direct negative correlation with post-operative clinical outcome.

Methods

Five hundred and seventy-six consecutive shoulders with a primarily arthroscopically treated full-thickness rotator cuff tear were followed up. Rotator cuff tear size (anteroposterior dimension) was measured intraoperatively with an arthroscopic measuring probe. The Constant score was used as an outcome measure and was measured pre-operatively and 1-year post-operatively.

Results

Five hundred and sixty-nine patients (99 %) were available for 1-year follow-up. The mean age of patients was 59.6 (SD 9.6) years. There were 225 (40 %) female and 344 (60 %) male patients. The mean size of the rotator cuff tear was 25 mm (SD 18). The mean pre- and post-operative Constant score was 52.3 (SD 17.4) and 74.2 (SD 15.5), respectively (p < 0.0001). The intraoperatively detected tear size correlated significantly with the pre-operative Constant score (r = −0.20, p < 0.0001). Furthermore, there was even stronger and significant correlation between the tear size and the final post-operative Constant score (r = −0.36, p < 0.0001). The correlation was similar between the genders, but the Constant scores were significantly lower in women (p < 0.0001). The lowest scores were detected in tears with infraspinatus tendon involvement.

Conclusions

The size of the rotator cuff tear linearly correlates with the Constant scores both pre- and post-operatively. The outcome of rotator cuff reconstruction is strongly related to the intraoperatively detected tear size.

Level of evidence

Retrospective comparative register study, Level III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87(6):1229–1240

    Article  PubMed  Google Scholar 

  2. Burns JP, Snyder SJ (2008) Arthroscopic rotator cuff repair in patients younger than fifty years of age. J Should Elbow Surg 17(1):90–96

    Article  Google Scholar 

  3. Charousset C, Grimberg J, Duranthon LD, Bellaiche L, Petrover D, Kalra K (2008) The time for functional recovery after arthroscopic rotator cuff repair: correlation with tendon healing controlled by computed tomography arthrography. Arthroscopy 24(1):25–33

    Article  PubMed  Google Scholar 

  4. Cho NS, Rhee YG (2009) The factors affecting the clinical outcome and integrity of arthroscopically repaired rotator cuff tears of the shoulder. Clin Orthop Surg 1(2):96–104

    Article  PubMed Central  PubMed  Google Scholar 

  5. Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM (2001) Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am 83-A(1):71–77

    Google Scholar 

  6. Cole BJ, McCarty LP 3rd, Kang RW, Alford W, Lewis PB, Hayden JK (2007) Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Should Elbow Surg 16(5):579–585

    Article  Google Scholar 

  7. DeFranco MJ, Bershadsky B, Ciccone J, Yum JK, Iannotti JP (2007) Functional outcome of arthroscopic rotator cuff repairs: a correlation of anatomic and clinical results. J Should Elbow Surg 16(6):759–765

    Article  Google Scholar 

  8. Dodson CC, Kitay A, Verma NN, Adler RS, Nguyen J, Cordasco FA, Altchek DW (2010) The long-term outcome of recurrent defects after rotator cuff repair. Am J Sports Med 38(1):35–39

    Article  PubMed  Google Scholar 

  9. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A(2):219–224

    Google Scholar 

  10. Gazielly DF, Gleyze P, Montagnon C (1994) Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res 304:43–53

    PubMed  Google Scholar 

  11. Gilbart MK, Gerber C (2007) Comparison of the subjective shoulder value and the Constant score. J Should Elbow Surg 16(6):717–721

    Article  Google Scholar 

  12. Gulotta LV, Nho SJ, Dodson CC, Adler RS, Altchek DW, MacGillivray JD (2011) Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II–prognostic factors for clinical and radiographic outcomes. J Should Elbow Surg 20(6):941–946

    Article  Google Scholar 

  13. Habermeyer P, Magosch P, Lichtenberg S (2006) Classifications and scores of the shoulder. Springer, Berlin, pp 17–34

    Google Scholar 

  14. Harryman DT II, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA III (1991) Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 73(7):982–989

    Google Scholar 

  15. Haviv B, Dolev E, Haber M, Mayo L, Biggs D (2010) Arthroscopic rotator cuff repair: clinical outcome of 607 patients. Knee Surg Sports Traumatol Arthrosc 18(12):1707–1711

    Article  PubMed  Google Scholar 

  16. Jost B, Pfirrmann CW, Gerber C, Switzerland Z (2000) Clinical outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 82(3):304–314

    CAS  PubMed  Google Scholar 

  17. Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR (2005) Normalization of the Constant score. J Should Elbow Surg 14(3):279–285

    Article  Google Scholar 

  18. Kirkley A, Griffin S, Dainty K (2003) Scoring systems for the functional assessment of the shoulder. Arthroscopy 19(10):1109–1120

    Article  PubMed  Google Scholar 

  19. Klepps S, Bishop J, Lin J, Cahlon O, Strauss A, Hayes P, Flatow EL (2004) Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med 32(7):1716–1722

    Article  PubMed  Google Scholar 

  20. Knudsen HB, Gelineck J, Sojbjerg JO, Olsen BS, Johannsen HV, Sneppen O (1999) Functional and magnetic resonance imaging evaluation after single-tendon rotator cuff reconstruction. J Should Elbow Surg 8(3):242–246

    Article  CAS  Google Scholar 

  21. Kukkonen J, Joukainen A, Itala A, Aarimaa V (2013) Operatively treated traumatic versus non-traumatic rotator cuff ruptures: a registry study. Ups J Med Sci 118(1):29–34

    Article  PubMed Central  PubMed  Google Scholar 

  22. Liu SH, Baker CL (1994) Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy 10(1):54–60

    Article  CAS  PubMed  Google Scholar 

  23. Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS (2009) Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy 25(1):30–39

    Article  PubMed  Google Scholar 

  24. Shen PH, Lien SB, Shen HC, Lee CH, Wu SS, Lin LC (2008) Long-term functional outcomes after repair of rotator cuff tears correlated with atrophy of the supraspinatus muscles on magnetic resonance images. J Should Elbow Surg 17(1 Suppl):1S–7S

    Article  Google Scholar 

  25. Sugaya H, Maeda K, Matsuki K, Moriishi J (2007) Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am 89(5):953–960

    Article  PubMed  Google Scholar 

  26. Wolf EM, Pennington WT, Agrawal V (2005) Arthroscopic side-to-side rotator cuff repair. Arthroscopy 21(7):881–887

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Turku University Hospital, P.O. Box 28, 20701, Turku, Finland

    Juha Kukkonen, Petri Virolainen & Ville Äärimaa

  2. Department of Biostatistics, University of Turku, Lemminkäisenkatu 1, 20014, Turun yliopisto, Finland

    Tommi Kauko

Authors
  1. Juha Kukkonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tommi Kauko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Petri Virolainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ville Äärimaa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juha Kukkonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kukkonen, J., Kauko, T., Virolainen, P. et al. The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 23, 567–572 (2015). https://doi.org/10.1007/s00167-013-2647-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-013-2647-0

Keywords

Search

Navigation