LAUSR

BACKGROUND There is limited evidence on clinical outcomes of APR and LDTT for posterosuperior mRCTs. We aimed to compare clinical outcomes of APR and LDTT for partially repairable posterosuperior mRCTs, and determine whether outcomes differ among tears that involve the teres minor. METHODS We retrieved records of 112 consecutive patients with mRCTs deemed partially repairable due to fatty infiltration (FI) stage ≥3 in one or more rotator cuff muscles. Twelve tears involved the subscapularis, 32 were managed conservatively, 14 treated by RSA and 7 treated by stand-alone biceps tenotomy. Of the remaining 47 shoulders, 26 had APR and 21 had LDTT. At a minimum of 12 months, we recorded complications, active forward elevation, external rotation, Constant-Murley score, American Shoulder and Elbow Surgeons score (ASES), subjective shoulder value (SSV), and simple shoulder test (SST). RESULTS There were no significant differences between the APR group and LDTT group in terms of follow-up (23.4±3.5 vs 22.1±4.1 months, p=0.242), Constant-Murley score (64.8±13.7 vs 58.9±20.0, p=0.622), ASES score (78.3±19.3 vs 74.4±14.5, p=0.128), active forward elevation (158.1±19.4 vs 142.8±49.1, p=0.698) or external rotation (33.3±17.4 vs 32.2±20.9, p=0.752). By contrast, the APR group had higher SSV (73.3±17.5 vs 59.5±20.0, p=0.010), and SST (8.3±2.4 vs 6.4±3.0, p=0.024). Univariable analysis revealed that advanced FI of the teres minor compromises Constant-Murley scores (β=-25.8, p=0.001), and tends to compromise ASES scores (β=-15.2, p=0.062). Multivariable analysis corroborated that advanced FI of the teres minor compromises Constant-Murley scores (β=-26.9, p=0.001), and tends to compromise ASES scores (β=-16.5, p=0.058). CONCLUSION Both APR and LDTT granted similar early clinical outcomes for partially repairable posterosuperior mRCTs, regardless whether the teres minor is intact or torn. Advanced FI of the teres minor was the only independent factor associated with outcomes, as it significantly compromised Constant-Murley scores and tended to compromise ASES scores.