OUTCOMES OF ROTATOR CUFF REPAIR AND AUGMENTATION PROCEDURES: A RETROSPECTIVE ANALYSIS OF HEALING AND PATIENT REPORTS

Shoulder injuries involving the rotator cuff are prevalent and often require surgical intervention. Rotator cuff repair procedures have historically faced challenges, including varying healing outcomes and high retear rates. However, recent advancements involve the use of augmented patches to enhance tendon-to-bone insertion, either mechanically or biologically. Existing literature supports the favorable outcomes associated with augmented patch techniques. Yet, no study has directly compared the results of augmentation and traditional rotator cuff repair methods. This study aims to assess the outcomes of patients who underwent either rotator cuff repair or augmentation procedures at a minimum of one year postoperatively. The evaluation utilizes patient-reported outcome scores and postoperative healing assessments through MRI. Our hypothesis is that individuals who underwent augmentation procedures would exhibit better healing and patient-reported outcomes. We conducted a retrospective analysis of 131 patients who underwent either rotator cuff repair (RCR) (N=42) or augmentation procedures (AUG) (N=21) between 2015 and 2022. The AUG group comprised 21 patients, with the remaining RCR patients matched for age and gender (2:1 ratio) to the AUG group. Data collected included pre- and post-operative MRIs, Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The primary outcome measure was healing, determined using MRI, with secondary outcomes being WORC and DASH scores. There were no significant differences between the groups regarding age, BMI, or sex (p>0.05). The mean postoperative MRI follow-up was 1.27 + 0.8 years for the RCR group and 1.3 + 1.0 years for the AUG group (p > 0.05). The AUG group demonstrated superior graft healing rates compared to the RCR group. Specifically, 92% of patients in the AUG group showed complete healing, with only 0.8% partially healed. In contrast, the RCR group exhibited full healing in 63% of patients, partial healing in 21%, and 25% of patients did not demonstrate any healing. Pre- and post-operatively, there were no differences in WORC or DASH scores between the two groups (p>0.05). Overall, both procedures significantly improved patient-reported outcomes (WORC & DASH) postoperatively (p< 0.05). The use of augmented patches for tendon-to-bone insertion, as observed in the AUG group, resulted in superior graft healing rates compared to traditional RCR. However, there were no significant differences between the groups in terms of patient-reported outcome scores (WORC and DASH). This suggests that both procedures led to similar improvements in functional outcomes. Further research is necessary to directly compare the efficacy of augmentation and RCR techniques in treating rotator cuff injuries.