| Author | Year | Level of evidence | Sample | Follow-up | Technique | Outcomes | Conclusion |
|---|---|---|---|---|---|---|---|
| Jost et al. [44] | 2000 | Prospective | 20 patients (mean age 59 years) |
- | Open repair | MRI evaluation | 1) 16/20 patients smaller re- rupture 2) Fatty degeneration of SS and IS, atrophy of SS and GH osteoarthritis progressed significantly 3) Clinical outcome significantly correlated with postoperative tear, stage of postoperative fatty degeneration of IS and SSC, postoperative acromiohumeral distance, postoperative GH osteoarthritis (p<0,05) Finally: significantly decreased pain (p=0,0026) and improved function (p=0,0005) and strength (p=0,0137) despite failure of repair |
| Voigt et al. [35] | 2010 | Level IV | 51 patients | 12 months | Arthroscopic suture bridge repair of supraspinatus | MRI SST and Constant score |
1) Re-tear rate 28,9% with no significant difference in clinical outcome between intact R.C. and re-tear group, but structural failure is not compatible with clinical failure 2) Age>60 negatively influenced tendon healing |
| Kim et al. [37] | 2012 | Retrospective | 77 patients | - | Arthroscopic suture bridge repair of full thickness cuff tears | MRI U/S UCLA, ASES, Constant-Murley scores |
1) Postoperative clinical outcomes improved in all patients without difference between healed R.C. and structural failure (p=0,438, p=0,625 and p-0,898 for UCLA, ASES and Constant score |
| Rhee et al. [51] | 2014 | Level III case-control study | 238 patients (two groups>70 years old and <70 years old) | Short mean follow-up (at least 6 months) |
- | MRI | 1) Both groups significant improvement in clinical outcomes with no significant difference between (p=0,161) 2) Retear rate 39,8% <70, 51,1% >70 3) Retear rate increased significantly depending on intraoperative size but not on age 4) No comparison of the functional outcome between re-tear and intact R.C. groups |
| McElvany et al. [2] |
2015 | Systematic review and meta-analysis | - | At least 6 months | All techniques | Radiological | 1) Mean re-tear rate 26,6% 2) Clinical outcomes were improved both in re-tear and in intact R.C. group 3) Re-tear rate associated with greater degree of fatty infiltration, larger tear size, advanced age and double-row repairs |
| Lubiatowski et al. [53] |
2012 | Retrospective study of 111 cases | 111 cases | At least 6 months | All techniques | UCLA, ASES and SST scores Radiological |
1) No significant difference in shoulder scores and patients’ satisfaction depending on quality of healing 2) Incomplete R.C. healing in 26% of cases 3) R.C. integrity after open or arthroscopic repair did not seem to affect clinical scores although recurrent tears may result in lower muscle strength, endurance and active motion |
| Russell et al. [61] | 2014 | Systematic review and meta-analysis of Level I and Level II studies | 14 studies (861 patients) | At least 1 year | All techniques | UCLA, ASES, Constant score | 1) Not clinically important improvement regardless of the structural integrity of the repair 2) Patients with intact repairs significantly greater strength in forward elevation and external rotation to those with retears |
| Choi et al. [54] | 2012 | Comparative study | 41 arthroscopic rotator cuff repair | 28 months (average) |
Double-pulley suture bridge repair | ASES, Constant score, UCLA | 1) Retear rate 19,5% 2) 75% within 6 months after operation and 25% >1year 3) Functional and clinical improvement independent of tear size and R.C. integrity |
| Kim et al. [49] | 2014 | Level IV retrospective study | 24 patients with full thickness rotator cuff tear | - | - | MRI and ultrasound scan ASES, VAS, UCLA, Constant-Murley, ROM |
1) Retear rate of 47,8% (smaller size than the initial) 2) No significant difference in clinical results between intact and retear group |
| Sugaya et al. [52] | 2007 | Level IV study | 106 patients | At least 6 months | Arthroscopic double-row rotator cuff repair | MRI and ultrasonography | 1) Arthroscopic double-row rotator cuff repair improved integrity compared with open and mini-open repair 2) Re-tear rates depend on initial tear size 3) Functional improvement depends on initial tear size 4) Function of R.C. remains even when small R.C. defects are recognized postoperatively by MRI |
| Paxton et al. [56] | 2013 | - | - | 10 years | - | ASES, SST and Constant scores Ultrasound |
Clinical improvement to those patients despite re-tear Conclusion: no structural healing is critical for massive tears due to the long-term satisfactory results at least in older patients |
| Moraiti et al. [55] | 2015 | Multicenter, prospective, comparative study of 40 patients <50 years and 40 >70 years Level IV therapeutic case series |
80 patients | 1 year | Arthroscopic repair | MRI and ultrasound Constant and modified Constant scores, patients’ satisfaction |
1) Healing rate lower in the older age group which was characterized by greater retraction in frontal plane and greater fatty infiltration 2) Functional outcome and satisfaction equal to both groups |