BACKGROUND:
Arthroscopic rotator cuff repair surgery is one of the most common shoulder procedures performed in the United States. While several studies have shown considerable symptomatic relief in the short-term following surgery, a relatively high rate of recurrent defects has led surgeons to question the long-term durability of this operation.

HYPOTHESIS:
Outcomes at a minimum of 15 years follow-up for patients who underwent all-arthroscopic rotator cuff repair are maintained and remain significantly improved compared to preoperative status.

METHODS:
193 patients underwent all-arthroscopic rotator cuff repairs from 2003 to 2005. Patient-reported outcomes were collected preoperatively and at 1, 2, 5, and 15+ years postoperatively. The primary outcome was American Shoulder and Elbow Surgeons (ASES) scores. Secondary outcomes included the Single Assessment Numeric Evaluation (SANE), Shoulder Activity Scale (SAS), Visual Analog Scale, and PROMIS Upper Extremity scores. Patient demographics, revision surgeries, and complications were recorded. Generalized estimating equations were used to model scores over time and multiple comparisons between timepoints were made using Tukey adjustment.

RESULTS:
60 patients were included with a mean follow-up of 16.5 years (range 15.8-17.7). The mean ASES score improved from 60.2 ± 18.8 preoperatively to 93.0 ± 9.4 at 15+ years (p < .0001). The mean pain visual analog score (VAS) decreased from 4.1 ± 0.7 preoperatively to 0.7 ± 0.3 at 15+ years (p < .0001). The average scores at 15+ years for SANE, SAS, and PROMIS UE were 87.8 ± 1.9, 8.8 ± 0.6, and 49.6 ± 1.3, respectively. 7 of 60 patients underwent revision surgery. Older age and female sex were associated with lower SAS scores at 15 years, while female sex was associated with lower PROMIS UE scores. There were no factors predictive of ASES or SANE scores.

CONCLUSION:
At long-term (15+ year) follow-up, patient-reported outcomes of all-arthroscopic rotator cuff repairs show significant improvement from baseline preoperative function and remain durable over 15 years. This information is useful in counseling patients regarding the long-term results of this procedure.





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