Arthroscopic Rotator Cuff Repair Prospective Evaluation With Sequential Ultrasonography

Background: Recent studies have demonstrated predictable healing after arthroscopic rotator cuff repair at a single time point, but few studies have evaluated tendon healing over time. Hypothesis: Rotator cuff tears that are intact on ultrasound at 1 time point will remain intact, and clinical results will improve regardless of healing status. Study Design: Cohort study; Level of evidence, 3. Methods: The Arthroscopic Rotator Cuff Registry was established to determine the effectiveness of arthroscopic rotator cuff repair with clinical outcomes using the American Shoulder and Elbow Surgeons score and ultrasound at 1 and 2 years, postoperatively. Patients were assigned to 1 of 3 groups based on ultrasound appearance: group 1, rotator cuff tendon intact at 1 and 2 years (n = 63); group 2, rotator cuff tendon defect at 1 and 2 years (n = 23); group 3, rotator cuff tendon defect at 1 year but no defect at 2 years (n = 7). Results: The ultrasound appearance was consistent at 1 and 2 years for 86 of the 93 patients (92.5%). The patients in group 1 had a significantly lower mean age (57.8 +/- 9.8 years) than the patients of group 2 (63.6 +/- 8.6 years; P=.04). Group 2 had a significantly greater rotator cuff tear size (4.36 +/- 1.6 cm) than group 1 (2.84 +/- 1.1 cm; P=.00025). Each group had a significant improvement in American Shoulder and Elbow Surgeons scores from baseline to 2-year follow-up. Conclusion: All intact rotator cuff tendons at 1 year remained intact at 2 years. A small group of patients with postoperative imaging did not appear healed by ultrasound at 1 year but did so at 2 years. Patients demonstrated improvement in American Shoulder and Elbow Surgeons shoulder scores, range of motion, and strength, regardless of tendon healing status on ultrasound.