Outcome of arthroscopic suturing repair of nonretracted full-thickness rotator cuff tears with fast-track rehabilitation

Abstract

Background: This study aims to evaluate the effectiveness of nonretracted full-thickness rotator cuff tears with arthroscopic rotator cuff suturing, and examine whether clinical functional outcomes are superior in the fast-track rehabilitation team. Objectives: To study the effects of arthroscopic rotator cuff suturing in the treatment of nonretracted full-thickness rotator cuff tears. Methods: From August 2013 to May 2018, 68 cases of nonretracted full-thickness rotator cuff tears underwent arthroscopic rotator cuff suturing repair. Postoperatively, 35 arms were suspended with a triangular arm sling, without immobilization at abduction or the 0-degree position. The remaining 33 arms were traditionally immobilized after operation for 6 weeks. All patients were evaluated using the University of California Los Angeles (UCLA) Shoulder Rating Scale (UCLA score), Constant-Murley score and VAS pain score before the operation and during the follow-up visits. Results: The follow-up time ranged from 12 to 36 months with an average of 12.1 months. All patients were satisfied with their operations. There were no significant differences in preoperative UCLA score, Constant-Murley score and VAS pain scores between the groups. Both groups showed significant improvement in these clinical function scores at follow-up. There were no significant differences in the UCLA score, Constant-Murley score, and VAS pain scores between the 2 groups at the last follow-up. However, the fast-track team had better activity motion especially in flexion and external rotation movement, suggesting that the triangular arm sling is as effective as the traditional immobilization in postoperative rehabilitation and allow patients to better perform rehabilitation exercises. Conclusions: Arthroscopic suturing repair is a safe, efficient and minimally invasive treatment for nonretracted full-thickness rotator cuff tears. For small nonretracted rotator cuff tears, compared with the traditional team, the fast-track rehabilitation team achieved faster recovery and higher patient’s satisfaction.