Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon
Authors: Baum Cornelia , Audigé Laurent , Stojanov Thomas , Müller Sebastian A. , Candrian Christian ,   ARCR_Pred Study Group, Müller Andreas M. , Rosso Claudio , Fankhauser Lena , Willscheid Gernot , Moroder Philipp , Akgün Doruk , Danzinger Victor , Gebauer Henry , Imiolczyk Jan-Philipp , Karpinski Katrin , Lacheta Lucca , Minkus Marvin , Paksoy Alp , Samaniego Eduardo , Thiele Kathi , Weiss Isabella , Suter Thomas , Müller-Lebschi Julia , Mueller Sebastian , Saner Markus , Haag-Schumacher Claudia , Tamborrini-Schütz Giorgio , Trong Mai Lan Dao , Buitrago-Tellez Carlos , Hasler Julian , Riede Ulf , Weber Sandra , Moor Beat , Biner Matthias , Fournier Sarah , Gallusser Nicolas , Marietan Deborah , Pawlak Sebastien , Spormann Christoph , Hansen Britta , Mamisch Nadja , Durchholz Holger , Bräm Jakob , Cunningham Gregory , Kourhani Abed , Ossipow Sarah , Simao Patricia , Lädermann Alexandre , Egli Rainer , Erdbrink Stephanie , Flückiger Remy , Lombardo Paolo , Pinworasarn Tawan , Scacchi Philipp , Weihs Johannes , Zumstein Matthias , Flury Matthias , Berther Ralph , Ehrmann Christine , Hübscher Larissa , Schwappach David , Eid Karim , Bensler Susanne , Fritz Yannick , Grünberger Nisha , Kriechling Philipp , Langthaler Daniel , Niehaus Richard , Nobs Raffaela , Benninger Emanuel , de Groot Quintin , Doert Aleksis , Ebert Sebastian , Grimm Philemon , Mottier Fabian , Pisan Markus , Schätz Jan , Schwank Ariane , Wiedenbach Julian , Scheibel Markus , Audigé Laurent , Bellmann Frederik , Brune Daniela , de Jong Marije , Diermayr Stefan , Endell David , Etter Marco , Freislederer Florian , Gkikopoulos Nikitas , Glanzmann Michael , Grobet Cécile , Jung Christian , Moro Fabrizio , Moroder Philipp , Ringer Ralph , Schätz Jan , Schwyzer Hans-Kaspar , Weber Béatrice , Wehrli Martina , Wirth Barbara , Nötzli Manuela , Franz Anne , Oswald Jörg , Steiger Birgit , Ameziane Yacine , Child Christopher , Spagna Giovanni , Candrian Christian , Del Grande Filippo , Feltri Pietro , Filardo Giuseppe , Marbach Francesco , Schönweger Florian , Jost Bernhard , Badulescu Michael , Lüscher Stephanie , Napieralski Fabian , Öhrström Lena , Olach Martin , Rechsteiner Jan , Scheler Jörg , Spross Christian , Zdravkovic Vilijam , Zumstein Matthias A. , Chlasta Adrian , Gerber Kate , Hayoz Annabel , Müller-Lebschi Julia , Schuster Frederick , Wieser Karl , Borbas Paul , Bouaicha Samy , Camenzind Roland , Catanzaro Sabrina , Gerber Christian , Grubhofer Florian , Hasler Anita , Hochreiter Bettina , Marcus Roy , Selman Farah , Sutter Reto , Wyss Sabine , Appenzeller-Herzog Christian , Aghlmandi Soheila , Ahlborn Ilona , Baum Cornelia , Eckers Franziska , Grezda Kushtrim , Hatz Simone , Hunziker Sabina , Stojanov Thomas , Taha Mohy , Tamborrini-Schütz Giorgio , Mueller Andreas Marc 
Published: January 2024

Background:

Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors—including age, sex, and tear severity—have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial.

Purpose:

To investigate the influence of tear etiology (degenerative vs traumatic) on functional and structural outcomes in patients with supraspinatus tendon tears.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients undergoing ARCR from 19 centers were prospectively enrolled between June 2020 and November 2021. Full-thickness, nonmassive tears involving the supraspinatus tendon were included. Tears were classified as degenerative (chronic shoulder pain, no history of trauma) or traumatic (acute, traumatic onset, no previous shoulder pain). Range of motion, strength, the Subjective Shoulder Value, the Oxford Shoulder Score (OSS), and the Constant-Murley Score (CMS) were assessed before (baseline) and 6 and 12 months after ARCR. The Subjective Shoulder Value and the OSS were also determined at the 24-month follow-up. Repair integrity after 12 months was documented, as well as additional surgeries up to the 24-month follow-up. Tear groups were compared using mixed models adjusted for potential confounding effects.

Results:

From a cohort of 973 consecutive patients, 421 patients (degenerative tear, n = 230; traumatic tear, n = 191) met the inclusion criteria. The traumatic tear group had lower mean baseline OSS and CMS scores but significantly greater score changes 12 months after ARCR (OSS, 18 [SD, 8]; CMS, 34 [SD,18] vs degenerative: OSS, 15 [SD, 8]; CMS, 22 [SD, 15]) ( P < .001) and significantly higher 12-month overall scores (OSS, 44 [SD, 5]; CMS, 79 [SD, 9] vs degenerative: OSS, 42 [SD, 7]; CMS, 76 [SD, 12]) ( P≤ .006). At the 24-month follow-up, neither the OSS (degenerative, 44 [SD, 6]; traumatic, 45 [SD, 6]; P = .346) nor the rates of repair failure (degenerative, 14 [6.1%]; traumatic 12 [6.3%]; P = .934) and additional surgeries (7 [3%]; 7 [3.7%]; P = .723) differed between groups.

Conclusion:

Patients with degenerative and traumatic full-thickness supraspinatus tendon tears who had ARCR show satisfactory short-term functional results. Although patients with traumatic tears have lower baseline functional scores, they rehabilitate over time and show comparable clinical results 1 year after ARCR. Similarly, degenerative and traumatic rotator cuff tears show comparable structural outcomes, which suggests that degenerated tendons retain healing potential.