Minimum 15-Year Outcomes and Return to Activity After Linked Tape Bridging Knotless Double-Row Rotator Cuff Repair

Abstract

Background:

Rotator cuff tears are common in older adults, and double-row repair is favored for its biomechanical strength and clinical outcomes. Although short-term and midterm results of linked tape bridging (LTB) knotless double-row repair are well established, data on long-term single-technique outcomes remain limited.

Purpose/Hypothesis:

The purpose of this study was to evaluate the long-term clinical and functional outcomes of knotless double-row rotator cuff repair. It was hypothesized that LTB knotless double-row rotator cuff repair would provide sustained functional outcomes but would demonstrate an increased failure rate beyond 10 years.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective review was performed for patients who underwent knotless double-row rotator cuff repair by a single surgeon (2008-2010). Patient-reported outcome measure scores, including those for the American Shoulder and Elbow Surgeons (ASES), shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), Single Assessment Numeric Evaluation (SANE), visual analog scale (VAS) for pain, 12-Item Short Form Health Survey (SF-12) physical component summary (PCS) and mental component summary (MCS), and patient satisfaction, were collected preoperatively and at 5-, 10-, and 15-year follow-up. Return to activity was assessed using a custom questionnaire. Failure was defined as a magnetic resonance imaging–confirmed retear requiring revision surgery or conversion to reverse total shoulder arthroplasty.

Results:

A total of 46 shoulders in 45 patients (85.3%) were available at a mean follow-up of 191.3 ± 10.9 months (15.9 years). ASES, VAS for pain, SANE, QuickDASH, and SF-12 PCS scores improved from baseline to 15 years (all P < .05), with no difference from 5 to 10 years or from 10 to 15 years. Median satisfaction was 10 (interquartile range, 8.5-10.0). Rates of return to recreational and sporting activities were 94.4% and 88.9%, respectively, with 55.6% resuming their preoperative activity at final follow-up. Overall, 9 failures (19.6%) occurred, mostly after 10 years, indicating a survivorship inflection after 10 years. There was 1 complication (2.2%).

Conclusion:

LTB knotless rotator cuff repair led to favorable long-term outcomes that were maintained beyond 15 years and enabled patients to sustain a high level of activity. However, a slight decline in survivorship was observed between 10 and 15 years.