Non-tendinous healing after repairing of retracted rotator cuff tear- An Imaging Study.

Abstract Background Follow-up magnetic resonance imaging (MRI) after rotator cuff repair can sometimes demonstrate healing with non-tendinous tissue that extends from the footprint to the retracted tendon end, which is inferred as fibrous tissue formation. The aim was to investigate this particular finding and its significance. Methods There were 494 eligible cases of healed superior medium- to massive-sized rotator cuff repairs, after the exclusion of re-tears. A retrospective review was performed for the three groups that were divided according to their MRI appearances of healing: Type I described the direct ‘healing’ of the tendon to the footprint, while Types II demonstrated the distinctive continuity of non-tendinous tissue from the footprint to the retracted tendinous portion, and the Type III also showed the similar appearance but with obvious thinning of the tissue, without any evidence of defect confirmed on the routine outpatient ultrasonography. Results Only 108 of 494 patients (21.9%) demonstrated Type I healing while the signs of ‘non-tendinous’ healing were evident for the rest, with the 116 patients (23.5%) being classified as Type III with attenuation. Comparing the preoperative tendon retraction, 34.8% and 37.2% of the Patte stages 2 and 3, respectively, resulted in Type III healing, which were significantly higher compared to that of the stage 1 (15.3%, P Conclusions Only a fifth of the rotator cuff repairs led to the direct ‘healing’ to the footprint, and the rest healed with the MRI appearances of non-tendinous tissue formation bridging between the retracted tendinous portions and the footprints. These MRI appearances did not represent the true tendinous tissue formation between the torn end of the tendon and the bone after healing. Such appearances did not seem to affect the clinical outcomes. Level of Evidence: Level IV; Case Series; Treatment Study;