A study of functional outcome of arthroscopic rotator cuff repair in rotator cuff tear patients

Introduction: Even though mini-open rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, all-arthroscopic repair of rotator cuff tear is now fast becoming a standard care for rotator cuff repair. The purpose of the study was to evaluate the functional outcome of arthroscopic rotator cuff repair in rotator cuff tear patients. Materials and Methods: This prospecutive study included 22 cases of rotator cuff tear patients of either sex fitting the inclusion criteria at the orthopedic department of Sanjay Gandhi Institute of Trauma and Orthopedics, Bangalore from September 2016 to December 2017. Patients included were between 18 to 70yrs of age with MRI proven rotator cuff tear who underwent all arthroscopic rotator cuff repair and willing to participate in study. Exclusion criteria included associated shoulder lesions, revision rotator cuff repair, irreparable tears, acj arthritis and rotator cuff tear arthropathy. Patients admitted with MRI proven Rotator cuff tear after meeting the inclusion and exclusion criteria are selected for the study. They will undergo detailed history, clinical and radiological evaluation. Arthroscopic rotator cuff repair by single row or double row technique using suture anchors by a single trained surgeon. Postoperative rehabilitation as per standard protocol. Postoperative evaluation done at, 3rd month, 6th month and 1 year. Range of motion, UCLA and ASES scoring done at preoperative and postoperative follow-ups. Results: A Prospective study with 22 patients is undertaken to study the functional outcome of Arthroscopic rotator cuff repair. The mean age in our study is 53.5 years majority are in the age group 40 to 60yrs. Out of 22 patients, 13 were male, 9 were female. Major part of our study contained partial thickness tears (59.1%) rather than full thickness tears (40.9%). 81.8 % (18) patients in our study had traumatic tears and 18.2%(4) patients had degenerative tears. There is significant improvement of flexion from 126.8° preoperatively to 147.0° postoperatively at 1year, abduction from 125.3° to 149.5°, external rotation from 51.1° to 80.2°, internal rotation from 40.45° to 67.5°. In our study according to UCLA score, out of 22 patients, 3 patients had poor outcome, 7 patients had average outcome, 8 patients had good outcome and 4 patients had excellent outcome. Mean UCLA score increased from 9.09 preoperatively to 28.50 postoperatively at the end of 1st year. Conclusion: Arthroscopic rotator cuff repair is as good as mini open repair in outcome. Advantages of arthroscopic rotator cuff repair include, less postoperative pain, small scar and ability to diagnose other shoulder pathologies. Patients need preoperative physiotheraphy to achieve good range of motion before surgery for better final outcome.