Background: In a previous study, twenty consecutive patients with a
rerupture of the rotator cuff, as documented with magnetic resonance imaging,
were found to have significantly less pain and better function and strength,
compared with the preoperative state, at 3.2 years postoperatively. It was the
purpose of this study to determine the clinical and structural outcomes of
these reruptures in the same twenty patients after a longer period of
Methods: At a mean of 7.6 years postoperatively, the twenty patients
were reexamined clinically and with standard radiographs and magnetic
resonance imaging with use of the same clinical, radiographic, and magnetic
resonance imaging criteria as were utilized in the review at 3.2 years. The
mean age at the time of final follow-up was sixty-six years.
Results: Nineteen of the twenty patients continued to be either very
satisfied or satisfied with the outcome. The relative Constant score averaged
88% and was not significantly different from the score at 3.2 years, which
averaged 83%. The mean scores for pain, function, and strength also had not
changed significantly. Overall, the twenty reruptures had not increased in
size, and eight of them had healed structurally at the time of the 7.6-year
follow-up. Seven of these eight reruptures had been of the supraspinatus
tendon only, and seven had been smaller than 400 mm2 at 3.2 years.
Twelve reruptures persisted, and five were larger than the preoperative tear.
Fatty infiltration of the infraspinatus muscle progressed significantly (p =
0.015) and the acromiohumeral distance decreased significantly (p = 0.006)
between the two follow-up periods. Neither fatty infiltration of the
supraspinatus and subscapularis muscles nor glenohumeral osteoarthritis
Conclusions: At an average of 7.6 years, the clinical outcomes after
structural failure of rotator cuff repairs remained significantly improved
over the preoperative state in terms of pain, function, strength, and patient
satisfaction. Overall, the reruptures that had been present at 3.2 years did
not increase in size. We also found that reruptures of the supraspinatus that
had been smaller than 400 mm2 had the potential to heal.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.