Arthroscopic Single-Row Repair in Full-Thickness Rotator Cuff Tear: A 60-Case Study of Functional Outcomes and Structural Integration at 2-Year Follow-Up

Background: The aim of this study was to assess practical results and tendon healing in individuals experiencing full-thickness rotator cuff tears handled using single-row arthroscopic rotator cuff repair (SR-ARCR), emphasizing its cost-effectiveness in resource-limited settings. Furthermore, the analysis includes evaluation of fatty muscle degeneration, glenohumeral joint arthritis, the significance of subscapularis tendon repair, and the impact of biceps tenotomy. Methods: 60 rotator cuff reconstructions with a minimum of 24-month follow-up and all treated by SR-ARCR were evaluated. Functional assessment was done by Constant-Murley Score (CMS) and University of California and Los Angeles (UCLA) Score for shoulder, and structural assessment was performed by Sugaya grading. While CMS and UCLA scores are expressed as unitless numerical scales derived from components involving pain, function, range of motion (ROM) (in degrees), and strength (in kilograms), the Sugaya grading system is a qualitative magnetic resonance imaging (MRI)-based classification without numerical units. Results: Mean follow-up was 35.93 ± 26.24 months with a minimum of 24 months. We noted a significant increase in post-operative mean CMS (range: 0-100) to 94.83 ± 7.78 (P < 0.001) and mean UCLA Score (range: 0-35) to 33.82 ± 6.70 (P < 0.001). Active forward flexion increased to 166.50 ± 11.62º (P < 0.001), external rotation (in degrees) increased to 79.17 ± 10.13º (P < 0.001), muscle strength (in kilograms) (0-25 kg) increased to 22.78 ± 3.32 (P < 0.001), and visual analogue scale (VAS) (0-10) decreased to 1.20 ± 0.75 (P < 0.001) post- operatively. Patients with Sugaya 1 grading (85% of patients) had CMS of 97.06 ± 5.21 (P < 0.001), Sugaya 2 (10%) had score of 82.67 ± 9.42 (P < 0.001), and Sugaya 3 or higher (5%) had score of 81.33 ± 6.35 (P < 0.001). Conclusion: SR-ARCR offered excellent outcomes cost-effectively with structural integration of rotator cuff at 24 months when tension-free repair of cuff was done