Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis

Abstract

Objective The effectiveness of arthroscopic rotator cuff repair (ARCR) on rheumatoid arthritis (RA) patients remains a controversial topic. This study investigates the mid‐term outcomes of ARCR in RA patients and identifies the factors influencing clinical efficacy. Methods This retrospective study enrolled RA patients with small or medium rotator cuff tears (RCTs) between February 2014 and February 2019. Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Constant–Murley scores were collected at each follow‐up time. Ultimately, magnetic resonance imaging (MRI) and X‐ray were employed to assess rotator cuff integrity and progression of shoulder bone destruction, respectively. Statistical methods used two‐way repeated‐measures ANOVA or generalized estimation equations. Results A total of 157 patients were identified and divided into ARCR (n = 75) and conservative treatment (n = 82) groups. ARCR group continued to be divided into small tear (n = 35) and medium tear (n = 40) groups. At the final, all scores were better in ARCR group than in the conservative treatment group (p 0.05). Radiographic assessment of the final follow‐up demonstrated that the progression rate in the small tear group (8.57%) was significantly lower than that in the medium group (27.50%, p < 0.05), and the retear rate of small tear group (14.29%) was significantly lower than that of the medium tear group (35.00%, p < 0.05). Conclusion ARCR could effectively improve the quality of life for RA patients with small or medium RCTs, at least in the medium term. Despite the progression of joint destruction in some patients, postoperative retear rates were comparable to those in the general population. ARCR is more likely to benefit RA patients than conservative treatment.

Keywords

• Arthroscopic Repair
• Mid‐Term Outcomes
• Rheumatoid Arthritis
• Rotator Cuff Tear