Margin convergence is effective in improving symptoms in patients with large-to-massive rotator cuff tear, despite a high chance of full-thickness retear (Free Paper Session V, Sports Medicine).

Abstract

<p><strong>Introduction:</strong> The aim is to report the 5-year outcomes of patients who underwent repair for large-to-massive rotator cuff tears.</p><p><strong>Methods:</strong> A retrospective study was conducted for patients who received primary rotator cuff repair with a minimum follow-up of 5 years. Postoperative magnetic resonance Imaging (MRI) was performed at the 2nd year post-operation. Clinical outcomes, including visual analogue scale (VAS), American Shoulder and Elbow Surgeons score (ASES), and shoulder forward flexion (FF) were compared between patients who received a direct complete repair (DCR) and those treated by a margin convergence (MC).</p><p><strong>Results:</strong> Fifty-three patients, including 33 in the DCR group and 20 in the MC group, were included. Despite a higher chance of full-thickness retears in the MC (82%), compared to DCR (23%), there were no significant differences between the two repair techniques in terms of mean VAS, ASES, and FF at both 2-year and 5-year follow-ups. Patients who received DCR showed improvement in VAS (p<0.001), ASES (p=0.002), and FF (p=0.049) between the 2-year and 5-year follow-ups, which was not observed in the MC group. A higher proportion of patients in the DCR group (90%), compared to the MC group (59%), achieved the minimum clinically important difference in VAS at the 5-year follow-up (p=0.01).</p><p><strong>Conclusion: </strong>MC is an effective technique for improving clinical outcomes in patients with large-to-massive rotator cuff tears, despite a high full-thickness retear rate on postoperative MRI. However, unlike those treated with DCR, further improvement in clinical outcomes between the 2-year and 5-year follow-ups was not observed in the MC group.</p>