The Influence of Surgical Timing on the Long-term Clinical Outcomes after Surgical Repair of Traumatic Rotator Cuff Tears

Background:
Early surgical treatment of traumatic rotator cuff tears may lead to superior clinical outcomes compared to non-operative or delayed surgery. An uncertainty remains regarding the critical surgical delay in these cases and surgery within 3 weeks and up to 24 months from injury has been associated with superior outcomes. This study examines the effect of surgical timing on the post-operative clinical outcomes for traumatic rotator cuff tears in patients younger than 50 years.

Methods:
One hundred patients, with an average age of 42 years (range, 22-50 years), underwent arthroscopic repair of traumatic rotator cuff tears. Of these, 37 patients were operated on within 6 months from injury, 27 patients within 6-12 months from injury and 36 patients after more than 12 months from injury. Postoperative clinical outcomes were retrospectively compared between the groups.

Results:
At a mean postoperative follow-up of 45 months, there was a significant improvement in the pain and function scores in all the study groups. At the latest follow-up, patients who were operated on within 6 months from injury had less shoulder pain compared to patients who were operated on after more than 12 months from injury (0.7±0.9 vs. 2.3±2.2 respectively; p <0.01), superior Oxford shoulder score (45±4 vs. 40±7 respectively; p=0.02), superior subjective shoulder value (91±6 vs. 84±9 respectively; p <0.01) and a higher overall satisfaction rate (89% vs. 64% respectively; p=0.03). Five patients required additional surgery due to recurrent symptomatic tears or postoperative shoulder stiffness.

Conclusions:
This study shows that surgical repair of traumatic rotator cuff tears within 6 months from injury leads to superior improvement in pain, clinical function and satisfaction rate compared to surgical repair after more than 12 months from injury.