Physical medicine & rehabilitation Kaohsiung Chang Gung Memorial Hospital Kaohsiung, Kaohsiung, Taiwan (Republic of China)
Objectives : Rotator cuff (RC) tears cause shoulder pain and substantial functional impairment, particularly in older adults. Although early arthroscopic repair is generally recommended for large or traumatic tears, postoperative recovery patterns across different tear sizes have not been fully characterized. This study investigated longitudinal changes in functional outcomes and quality-of-life after arthroscopic RC repair.
Design: Patients with MRI or ultrasound confirmed RC tears who underwent arthroscopic repair between August 2021 and December 2023 were enrolled. Tear size and tendon involvement were determined from operative reports. Shoulder range of motion (ROM), strength, and functional scores (American Shoulder and Elbow Surgeons [ASES] score, Western Ontario Rotator Cuff [WORC] Index, World Health Organization Quality of Life-Brief [WHOQOL-BREF], and EuroQol-5 Dimension [EQ-5D]) were assessed preoperatively and up to 12 months postoperatively. Longitudinal changes across different tear-size groups were analyzed using linear mixed-effects models. A p-value < 0.05 was considered statistically significant.
Results: A total of 201 patients were included. Supraspinatus involvement was nearly universal, whereas infraspinatus involvement increased with tear size. All groups demonstrated time-dependent improvements in shoulder ROM and strength. Tear size significantly affected recovery trajectories for flexion and abduction ROM.Larger full-thickness tears exhibited lower baseline flexion and abduction ROM, with large and massive tears starting at significantly reduced values compared with partial-thickness tears. Tear size also had significant effects on external rotation, internal rotation, abduction, and flexion strength. Larger tear sizes were associated with significantly lower baseline strength levels compared with partial-thickness tears. Functional and quality-of-life scores improved consistently over 12 months among all tear-size group.
Conclusion: Arthroscopic RC repair resulted in substantial and consistent improvements in ROM, strength, and quality of life across all tear-size groups. Tear size was associated with differences in baseline function and postoperative recovery patterns, with larger tears demonstrating lower initial ROM performance and strength and distinct recovery trajectories.
