Glenohumeral osteoarthritis is a common comorbidity in patients with rotator cuff tears. However, the efficacy of rotator cuff repair in patients with concomitant glenohumeral osteoarthritis is still heavily debated. Thus, the purpose of this study is to compare the clinical and functional outcome measures following arthroscopic rotator cuff repairs in patients with concomitant glenohumeral osteoarthritis to those without.
A retrospective review of 206 consecutive patients who underwent arthroscopic supraspinatus repairs (both isolated and with accompanying infraspinatus/subscapularis involvement) between 2013-2018 with a minimum of one-year follow-up was performed. Patients were separated into two groups based on presence or absence of concomitant glenohumeral osteoarthritis. The primary outcome was failure of repair, defined as need for revision repair or a re-tear confirmed on postoperative MRI. Secondary outcomes were patient-reported outcome measures (PROs) including visual analog pain scale (VAS), subjective shoulder value (SSV), and American Shoulder and Elbow Surgeons (ASES) score; active range of motion (ROM), and strength testing. Within the osteoarthritis cohort, a subgroup analysis was conducted to compare outcomes between mild versus moderate/severe osteoarthritis.
There were 91 patients in the glenohumeral osteoarthritis group and 115 patients in the control group. There was a significant difference in the postoperative forward flexion (FF) (153.55 ± 21.07 vs. 160.14 ± 17.26 degrees, p=0.001) and external rotation (ER) (46.91 ± 11.95 vs. 52.25 ± 11.60 degrees, p=0.001) ROM between the glenohumeral osteoarthritis and control groups, respectively. There were no significant differences between groups for revisions repairs, retears, postoperative internal rotation (IR) ROM, all preoperative ROM, all PROs, and all strength parameters (all p > 0.05). For the subgroup analysis, there were 70 patients in the mild osteoarthritis group and 21 patients in the moderate/severe osteoarthritis group. There was a significant difference in the postoperative FF strength (88.4% vs. 61.9% with 5/5 strength, p=0.010) and ER strength (89.9% vs. 71.4% with 5/5 strength, p=0.046) between the mild and moderate/severe groups, respectively. There were no significant differences between the groups for all other outcome measures.
Rotator cuff repair remains an excellent treatment in patients with concomitant glenohumeral osteoarthritis. The data from this study demonstrates that rotator cuff repairs in patients with concomitant glenohumeral osteoarthritis have similar clinical and functional outcomes as repairs in patients without osteoarthritis with the exception of a slightly decreased postoperative FF and ER ROM. Patients with moderate to severe osteoarthritis may have slightly decreased FF and ER strength outcomes compared to those with mild osteoarthritis.

Copyright © 2021. Published by Elsevier Inc.

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