Does acromioclavicular joint tenderness affect the outcome of rotator cuff repair? A prospective cohort study

Purpose: The purpose of this study was to assess the functional outcome of rotator cuff repair (RCR) without distal clavicle excision (DCE) in patients with degenerative rotator cuff tear and acromio-clavicular joint (ACJ) tenderness. Methods: A cohort of 70 patients undergoing arthroscopic RCR without DCE were prospectively evaluated. Parameters such as the presence of ACJ arthritis on imaging and long head of biceps tendon (LHBT) pathology (intra-operative) were recorded. The ACJ tenderness and clinical outcome scores including Oxford shoulder score and quick-disability of arm, and shoulder and hand score were evaluated preoperatively and at 1-year postoperatively. Results: Four patients were lost to follow up. Of remaining 66 patients, ACJ tenderness was found in 50% of the total study population. ACJ tenderness showed significant positive correlation with biceps tendinopathy (R = 0.37, P = 0.002). Postoperatively, there was significant improvement in clinical outcome scores which were comparable in patients with or without ACJ tenderness. Among patients with tender ACJ, the tenderness resolved completely in 78.7% of patients. Conclusions: ACJ tenderness did not adversely affect the outcome following RCR. Furthermore, the patients with ACJ tenderness have higher incidence of LHBT tendinopathy.