FUNCTIONAL OUTCOMES AND TENDON HEALING FOLLOWING ARTHROSCOPIC SINGLE-ROW REPAIR OF LARGE AND MASSIVE ROTATOR CUFF TEARS

Abstract

Introduction: Large and massive rotator cuff tears frequently cause pain, functional limitation, and weakness. Single-row arthroscopic repair is widely performed due to its technical simplicity and cost-effectiveness. The study aims to evaluate functional outcomes, tendon healing, and structural changes following single-row repair of large and massive rotator cuff tears. Methods: We retrospectively analyzed 44 patients (23 men, 21 women; mean age 62 ± 7.4 years) who underwent arthroscopic single-row repair between 2021 and 2024. Preoperative assessment included tear size, tendon retraction (Patte), fatty infiltration (Goutallier), and tangent sign. Functional outcomes were measured using UCLA Shoulder Rating Scale and VAS. Postoperative tendon healing was assessed in 22 patients (50% of the cohort) via MRI. Results: Mean follow-up was 20.2 months. UCLA scores improved from 13.6 ± 2.9 to 30.3 ± 2.5, and VAS decreased from 7.4 ± 0.6 to 2.5 ± 0.9 (p < 0.001). Complete repair was achieved in 65.9% of cases; medialization (<10 mm) in 63.6%. MRI showed 38.3% intact tendons (Sugaya I–II) and 61.7% partial/full-thickness defects (Sugaya III–V). Some patients demonstrated improved tendon retraction and apparent improvement in fatty infiltration. No major complications were observed. Conclusions: Single-row arthroscopic repair significantly improves function and reduces pain in large and massive rotator cuff tears. Despite a moderate re-tear rate, tendon quality and fatty degeneration may improve, supporting single-row repair as a clinically effective option when double-row repair is not feasible.