Primary Arthroscopic Repair for Massive Rotator Cuff Tears Results in Good Shoulder Function, Low Pain, and Satisfactory Outcomes at 2-Year Minimum Follow-Up

Purpose: To evaluate outcomes of patients who underwent primary arthroscopic repair for massive rotator cuff tears (MRCTs). Methods: Patients with MRCTs (full-thickness tear of 2 or more tendons or full-thickness tear >= 5 cm) who underwent arthroscopic repair with a minimum follow-up of 2 years were retrospectively reviewed (n = 51). All patients had preoperative magnetic resonance imaging used to characterize pattern of tear, degree of fatty degeneration (Goutallier classification), and degree of rotator cuff arthropathy (Hamada classification). Outcomes were determined by American Shoulder and Elbow Surgeons (ASES) scores and Penn Shoulder Scores (PSS). Results: A total of 51 patients with a minimum 2.3-year follow-up (mean, 5.4 years; range, 2.3-9.7 years) were included in this study. Mean ASES score was 46.1 f 7.8 (95% CI, 43.9-48.3) for pain and 39.4 f 12.1 (95% CI, 36.0-42.8) for function. Total ASES score averaged 85.5 f 18.4 (95% CI, 80.4-90.7). PSS had a mean pain score of 26.8 f 4.4 (95% CI, 25.4-28.1), a mean satisfaction score of 7.9 f 2.9 (95% CI, 7.0-8.2), and a mean function score of 48.5 f 13.5 (95% CI, 44.7-52.3). Total PSS averaged 83.2 f 19.6 (95% CI, 77.7-87.7). No correlation was found between Goutallier grade and ASES/PSS scores or between Hamada grade and ASES/PSS scores. Three patients underwent reoperation after primary arthroscopic repair of an MRCT (5.9%). Conclusions: Patients with MRCTs who undergo primary arthroscopic repair have postoperative outcome scores indicative of good shoulder function, low pain, and high satisfaction. The rate of reoperation for individuals who underwent primary arthroscopic repair with MRCTs was low at 6%. Level of Evidence: Level IV, retrospective case series.