JSES Rev Rep Tech. 2026 Jun 3;6(3):100791. doi: 10.1016/j.xrrt.2026.100791. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: Rotator cuff (RC) tear size is known to influence post-operative outcomes and recovery following arthroscopic rotator cuff repair (ARCR). However, the trajectory of recovery has not been fully explored. This study aims to evaluate patient-reported outcomes pre-operatively, 6 months (6ms) and 2 years (2ys) after ARCR, stratified according to tear size.
METHODS: A retrospective cohort study evaluated outcomes of 136 patients who underwent ARCR. RC tear size was categorized into small (<1 cm), medium (1-3 cm), and large (3-5 cm) groups. Outcome measures included range of movement forward flexion and range of movement abduction, visual analog scale (involved shoulder), Constant score, University of California, Los Angeles score and Oxford Shoulder Score. Paired t-tests were conducted within each tear-size group, comparing pre-operative with 6m outcomes and 6m with 2y outcomes. Between-group differences in change scores were examined using one-way analysis of variance, and multivariate regression analysis was performed to identify independent predictors of outcome. Effect size analysis using Cohen d was performed to complement primary statistical findings, given the underpowered cohort sizes.
RESULTS: All groups displayed significant improvement in all measured outcomes from baseline to 6 months (P < .05). Small and medium tears demonstrated continued significant improvements in several outcomes from 6 months to 2 years (Constant score +7.6 and +7.4, respectively, P < .05; Oxford Shoulder Score +4.3 and 0.017, respectively, P < .05) while large tears did not (P > .05). Between-group analysis of variance demonstrated no significant difference in the degree of change scores for both time intervals (P > .05). Multivariate regression analysis concluded that tear size is not an independent predictor of 2-year outcomes (P > .05). Effect size analysis revealed predominantly moderate-to-large early effect sizes across all groups.
CONCLUSION: ARCR are associated with substantial early improvement across all tear sizes at 6 months, with diminishing returns thereafter. Although larger tear sizes have lower post-operative readings, the equally low pre-operative baseline readings result in similar net numerical improvements across all groups.
PMID:42389647 | PMC:PMC13321195 | DOI:10.1016/j.xrrt.2026.100791
