Patient-Reported Outcomes and Factors Influencing Partial-Thickness Articular-Sided Rotator Cuff Tear Transtendinous Repairs.

Abstract

Purpose: To evaluate patient-reported outcomes of the transtendinous repair technique for partial-thickness articular-sided tendon avulsions (PASTA) using patient-acceptable symptomatic state (PASS) thresholds.

Methods: Chart reviews included patients who underwent a transtendinous arthroscopic rotator cuff repair by a single surgeon for a high-grade PASTA from January 2007 to December 2020. Inclusion criteria included patients 18 years or older who underwent surgery to repair a partial-thickness articular-sided rotator cuff tear. Exclusion criteria included previous ipsilateral arthroscopic shoulder procedures, rheumatoid arthritis, and severe glenohumeral arthritis. Patient-reported outcome data, including Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons (ASES), and visual analog scale, were retrospectively collected, as well as demographic data. These values were compared with a previously reported PASS threshold.

Results: Eighty-four patients with a mean follow-up of 6.8 (standard deviation [SD] = 3.6) years were included in the study. All patients underwent arthroscopic rotator cuff repair for a high-grade PASTA tear. The mean ASES index score was 90.11 (SD = 12.79) at follow-up year (mean = 6.8, SD = 3.6), with 58 out of 84 (69%) patients meeting the PASS threshold. Seventy-five out of 84 (89%) participants reached the PASS threshold for the Single Assessment Numeric Evaluation assessment, with a mean score of 94.18 (SD = 7.49) at follow-up year. The mean visual analog scale was 1.24 (SD = 1.9) at follow-up year. Fifty-eight of 85 participants (68%) met PASS standards for both the ASES and Single Assessment Numeric Evaluation assessments.Achieving PASS in ASES was not significantly predicted by age, sex, athletic status, number of prior procedures, or lifestyle risk factors. However, participants classified as laborers showed a notable trend toward a lower likelihood of achieving PASS, suggesting that higher physical workload may negatively impact performance outcomes. Similarly, those with systemic disease tended to have reduced probability of achieving PASS.

Conclusions: When clinically indicated, partial-thickness articular-sided rotator cuff tears can be reliably repaired via a transtendinous technique with demonstrated postoperative Patient Reported Outcomes Measures averages consistent with previously reported literature. Laborers, a Workers' Compensation claim, and history of gout all showed significantly worse Patient Reported Outcomes Measures after PASTA repairs.

Level of evidence: Level IV, retrospective case series.