Patient outcomes for arthroscopic repairs rotator cuff repairs have been analyzed almost exclusively by means of a single post-operative follow-up date. The purpose of this study was to examine the results of arthroscopic repairs of large rotator cuff tears performed by a single surgeon, both serially and at a two-year endpoint following surgery.

Seventeen patients with retracted U-shaped tears involving the supraspinatus were repaired arthroscopically between June 2002 and October 2003 using marginal convergence suturing followed by tendon-to-bone fixation. Patients were assessed at six weeks, three months, six months, one year, and two years following surgery. Each assessment consisted of a medical history, physical examination, and the Western Ontario Rotator Cuff (WORC®) questionnaire. Evaluation at the two-year study endpoint also included range of motion measurements and a modified University of California Los Angeles (UCLA) scoring system.

During the follow-up period, the three-month average WORC score (63.1%) was the first statistically significant difference from the pre-operation mean of 40.7%. WORC scores peaked at six months post-op (75.5%), and plateaued after this date. The one- and two-year average WORC scores (74.2% and 69.5%, respectively) did not differ significantly from the peak score achieved after six months. At the final two-year follow-up, the average UCLA score was 27.1. Fourteen of seventeen patients (78%) were satisfied with their surgical outcome. When workers’ compensation claimants were excluded from the results, the average UCLA score was 32.0 and patient satisfaction was 100%. There was no significant difference in average range of motion between the surgically-repaired shoulder and the unaffected shoulder.

This study shows that shoulder function improved significantly by three months after arthroscopic rotator cuff surgery and plateaued at six months post-op as measured by the WORC index. There was no statistically significant change in WORC score after six months post-op.

To prospectively evaluate patient outcome in terms of stability, function and satisfaction following an arthroscopic anterior Bankart repair in order to identify patient characteristics, surgical technique or instrumentation linked to poor outcomes. These findings can then be used to refine selection criteria such that patient benefit from the shoulder instability repair is maximised.

Between April 2002 and June 2004 thirty-seven arthroscopic anterior Bankart lesion repairs were performed by a single orthopaedic surgeon. Data on concomitant shoulder pathology, surgical technique utilised and instrumentation used was recorded for each patient. Reoccurrence rate, patient satisfaction and range of motion were evaluated pre-operatively, and then six weeks, three months, six months, twelve months and twenty-four months post-operatively.

Four of thirty-seven patients (10.8%) experienced at least one post-operative reoccurrence defined as a subluxation or dislocation. There was a statistically significant association between the presence of an inverted pear-shaped glenoid and increased incidence of reoccurrence (p < 0.05). Patients’ satisfaction with their shoulders increased significantly from 43% pre-operatively to 71% at the two-year follow-up, as measured by the Western Ontario Shoulder Instability (WOSI) scale. There were no significant differences in range of motion between the patients’ surgically repaired and unaffected shoulders.

An arthroscopic repair of an anterior Bankart lesion can yield good-to-excellent results for the majority of patients with respect to stability, function and satisfaction. The presence an inverted pear-shaped glenoid is mostly strongly correlated with an increased incidence of reoccurrence. Patients should be screened pre-operatively to identify this bony abnormality such that it can be addressed appropriately during surgery.