Clinical outcome of rotator cuff repair in patients with mild to moderate glenohumeral osteoarthritis

Abstract

Purpose Osteoarthritis (OA) in the glenohumeral joint is a concomitant lesion with rotator cuff tear that commonly occurs in older patients. The authors aimed to evaluate the effect of associated OA on the treatment outcome of rotator cuff repair. Methods A total of three hundred and forty-eight patients who underwent full-thickness arthroscopic rotator cuff repair were retrospectively reviewed, and the data were prospectively collected. The severity of OA was evaluated using the Samilson and Prieto method preoperatively and the Outerbridge classification intraoperatively. The patients were divided into the small-to-medium group and large-to-massive group according to rotator cuff tear size and were evaluated for presence or absence of OA. The postoperative clinical outcomes were assessed using the visual analog scale for pain, simple shoulder test (SST), University of California-Los Angeles, Constant, and American Shoulder and Elbow Surgeons (ASES) scoring systems at baseline and at final follow-up. Results Forty-five patients were diagnosed with glenohumeral OA (12.9%). Overall, no significant differences were observed in demographic and baseline data between the two groups according to the presence or absence of OA. The clinical symptoms of both groups significantly improved at the final follow-up. At the final follow-up, no significant differences were found in the VAS for pain, SST, UCLA, Constant, and ASES scores between the two groups. In the large-to-massive tear group, patients with OA had significantly inferior clinical results compared with those without OA. ConclusionThe clinical outcome scores improved after rotator cuff repair regardless of the presence of concomitant OA. However, glenohumeral OA should be considered as a potential negative prognostic factor in patients with large-to-massive rotator cuff tears. Level of evidence III.

Arthritis Severity and Medical Comorbidities Are Prognostic of Worse Outcomes Following Arthroscopic Rotator Cuff Repair in Patients With Concomitant Glenohumeral Osteoarthritis

“…As such, most of the literature regarding RCR in patients with glenohumeral OA involves cases with mild OA. 17 , 18 However, a previous comparative study with this same patient cohort found that RCR may be a successful treatment with outcomes comparable with those without OA, and may still be a viable treatment option in patients with moderate-to-severe glenohumeral OA but with decreased strength and ROM outcomes compared with mild OA. 19 …”

“… 17 , 18 , 19 In addition, one study found no differences in range of motion (ROM), strength, or patient-reported outcomes between the 2 groups, 18 whereas others found slightly lower postoperative ROM among patients with glenohumeral OA. 17 , 19 …”

“… 12 , 15 , 16 Studies comparing rotator cuff repair (RCR) in patients with glenohumeral OA with those without have shown no difference in repair failure rates. 17 , 18 , 19 In addition, one study found no differences in range of motion (ROM), strength, or patient-reported outcomes between the 2 groups, 18 whereas others found slightly lower postoperative ROM among patients with glenohumeral OA. 17 , 19 …”

Relationship Between Preoperative Shoulder Osteoarthritis Severity Score and Postoperative PROMIS-UE Score After Rotator Cuff Repair

“…Two studies reported that patients with radiographically diagnosed GHOA preoperatively had worse postoperative PRO scores after RCR compared with those without preoperative GHOA. 15 , 17 In contrast, other studies found no difference in postoperative PROs between those with and without preoperative GHOA. 13 A recent study by Reddy et al 24 found no difference in revisions, retear rates, or PROs in patients with GHOA undergoing cuff repair compared with those without GHOA.…”

“…A sizable subset of patients undergoing RCR may have preoperatively detectable GHOA, with reported rates ranging from 12.9% to 28% in the literature. 15 , 17 , 19 , 21 Most studies rely on radiographic scoring systems to diagnose GHOA, including the Samilson-Prieto, Kellgren-Lawrence, and Guyette systems. While these scoring systems have high inter- and intraobserver reliability, they classify GHOA based on joint space narrowing, osteophyte presence, and sclerosis, 26 which may be more difficult to detect in early disease.…”