Outcomes of footprint medialization and bone marrow stimulation in chronic retracted rotator cuff tears.

Background: This study compared the clinical and radiological outcomes of chronic retracted rotator cuff tears where complete footprint coverage cannot be achieved, using two treatments: footprint medialization with bone marrow stimulation and conventional incomplete repair.

Methods: This retrospective study included 87 patients who underwent arthroscopic rotator cuff repair with incomplete footprint coverage. The included patients were divided into group 1 (54 patients with footprint medialization and bone marrow stimulation) and group 2 (33 patients with conventional repair). Medialization and bone marrow stimulation were performed if the tendon did not cover a footprint of ≥1 cm2. Clinical outcomes, including a visual analog scale for pain score, range of motion, American Shoulder and Elbow Surgeons score, Constant-Murley score, and patient satisfaction, were evaluated preoperatively and at follow-up. Radiological healing was assessed using magnetic resonance imaging or computed tomography arthrography at 6 months and ultrasound at 2 years.

Results: Both groups showed significant improvements in clinical outcomes from preoperative levels. Group 1 demonstrated better outcomes in all measures at the final follow-up than group 2. Active range of motion improved significantly in both groups, with no significant postoperative differences. At 2 years postoperatively, group 1 had a significantly lower retear rate (14.8%) than group 2 (36.4%) (P=0.020).

Conclusions: In this study, the group that underwent footprint medialization and bone marrow stimulation for chronic retracted rotator cuff tears, in which complete footprint coverage was not possible, exhibited a lower retear rate and better clinical outcomes than the group that underwent conventional incomplete repair, with a minimum follow-up period of 2 years. Level of evidence: III.