The Effect of Trauma History and Symptom Duration on Repair Integrity in 2335 Consecutive Arthroscopic Rotator Cuff Repairs.

Abstract

Background: Few studies have assessed the impact of trauma history and preoperative symptom duration on cuff integrity after arthroscopic rotator cuff repair (RCR).

Purpose: To assess the hypothesis that acute, traumatic rotator cuff tears are less likely to retear after arthroscopic RCR compared with chronic, atraumatic tears.

Study design: Cohort study; Level of evidence, 3.

Methods: We conducted a post hoc analysis of prospectively collected data for 2335 consecutive patients who underwent primary arthroscopic RCR and were evaluated for retear on ultrasound 6 months postoperatively. A single-row knotless repair technique was used for all patients. The cohort was divided into patients who recalled a specific event that instigated their symptoms ("traumatic" group) and those who did not ("atraumatic" group). Chi-square test was utilized to assess the difference in retear rate between the traumatic and atraumatic groups. Multivariate logistic regression analyses were performed to identify independent predictors of retear, and receiver operating characteristic curve analysis was used to evaluate the accuracy of the regression equations.

Results: The traumatic and atraumatic groups consisted of 1489 and 846 patients, respectively. There was no significant difference in retear rate between the traumatic and atraumatic groups (13% and 11%, respectively; P = .14). In the entire cohort, trauma history and preoperative symptom duration were not predictive of retear. In the traumatic group, larger tear size area was the strongest independent predictor of retear (area under the curve [AUC], 0.76; 99% CI, 0.70-81), followed by longer operative time (AUC, 0.69; 99% CI, 0.64-0.74), older patient age (AUC, 0.68; 99% CI, 0.63-0.73) and full-thickness tear (AUC, 0.66; 99% CI, 0.61-0.71). In the atraumatic group, larger tear size area was the strongest independent predictor (AUC, 0.76; 99% CI, 0.68-0.83), followed by older patient age (AUC, 0.67; 99% CI, 0.59-0.75) and full-thickness tear (AUC, 0.66; 99% CI, 0.58-0.73).

Conclusion: Trauma history and preoperative symptom duration did not affect cuff integrity 6 months after arthroscopic RCR. More important factors associated with enhanced repair integrity included smaller tear size and younger patient age.