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Arthroscopic Rotator Cuff Repair in Overhead-throwing Athletes

Dennis Liem, MD^,*, Sven Lichtenberg, MD, Petra Magosch, MD and Peter Habermeyer, MD, PhD

From the Department of Orthopaedics, University Hospital of Muenster, Muenster, Germany, and Shoulder and Elbow Service, ATOS–Clinic Heidelberg, Heidelberg, Germany

^* Address correspondence to Dennis Liem, MD, Department of Orthopaedics, University Hospital of Muenster, Albert Schweitzer Street 33, 48149 Muenster, Germany (e-mail: dennisliem{at}web.de).

Background: When overhead-throwing athletes suffer from a rotator cuff tear, their ability to perform sporting activities is significantly impaired.

Hypothesis: Arthroscopic rotator cuff repair allows amateur overhead-throwing athletes to return to their preoperative level of overhead-throwing sports.

Study Design: Cohort study; Level of evidence, 3.

Methods: Twenty-one overhead-throwing athletes (14 male and 7 female; average age, 58.9 years, range, 46–69 years) were reviewed for clinical outcome with the Constant Score and structural integrity of the repair on magnetic resonance imaging. The average follow-up was 25.7 months (24–29 months). Athletes were asked to retrospectively assess their sporting activity for pain, strength, endurance, and range of motion before onset of symptoms, preoperatively and at follow-up. They also were asked to evaluate their overall performance as a percentage of their original performance (0% to 100%). Retear rates and Constant Scores were compared with those of 32 patients who were not overhead-throwing athletes and who were operated on during the same time span.

Results: Patients significantly improved their Constant Score from 54.9 to 84.2 (P < .001). Sporting activity was not significantly influenced by repair integrity; the retear rate was 23.8% (5/21). There was no significant difference for retear rate (25%; 8/32) or clinical outcome (Constant Score 84.5, P = .993) compared with patients who were not involved in overhead-throwing sports or any sports. All patients returned to their overhead-throwing sport an average of 6.3 months (3–12 months) after the surgery. Participation (2.1 per week) and duration (2.3 hours) of overhead-throwing activity postoperatively were not significantly lower than before the patient was injured (2.2 per week, P = .290; and 2.4 hours, P = .285). Patients estimated their overall activity level to be 91.9% of their original, noninjured condition, which was significantly improved from the preoperative condition of 34.8% (P < .001).

Conclusion: Arthroscopic rotator cuff repair led to good clinical results in this group of overhead-throwing athletes. Patients were able to return to overhead-throwing sports, most of them at the same preoperative level.

Key Words: rotator cuff • overhead-throwing athlete • cuff integrity • arthroscopic rotator cuff repair