Margin Convergence Yields Comparable Clinical Outcomes With Repair Using the Interval Slide Technique in Patients Who Had Undergone Complete Repair of Large-to-Massive Rotator Cuff Tears

Abstract

Purpose: To compare the outcomes of complete repairs for large-to-massive rotator cuff tears between patients who underwent the margin convergence (MC) or interval slide technique (IS). Methods: A retrospective study was conducted. The inclusion criteria included patients who received primary repairs using either MC or IS to address a large-to-massive rotator cuff tear between 2007 and 2020. Clinical outcomes, including visual analog scale score, American Shoulder and Elbow Surgeons score, and active shoulder forward flexion (FF), were assessed at the 2-year follow-up. Minimal clinically important difference (MCID) was calculated. Magnetic resonance imaging (MRI) was performed at the 2-year follow-up. Results: The number of patients operated on with IS and MC technique was 59 and 24, respectively, including 42 male and 41 female patients, with an average age of 62.5 ± 10 years. The 2-year follow-up rate was 91%. Postoperative MRIs were performed at 17.8 ± 7.3 months. The rates of full-thickness retear were 88% for MC and 27% for IS. One patient (4%) who was operated on with MC, compared with 2 patients who underwent IS (3%), received revision surgeries. There were no differences between the 2 repair techniques in terms of visual analog scale score, American Shoulder and Elbow Surgeons Score, and FF at the 2-year follow-up. However, more patients in the IS group achieved MCID for ASES (93% and 67%, respectively; P = .006) and FF (62% and 30%, respectively; P = .016), compared with those who underwent MC. The odds ratio were 7.2 (95% confidence interval 1.6-33) and 3.7 (95% confidence interval 1.2-11.3), respectively. Conclusions: Both margin convergence and interval slide techniques are effective methods for improving clinical outcomes in patients with large-to-massive rotator cuff tears, despite a 3-fold greater full-thickness retear rate observed on postoperative MRI and a lower likelihood of achieving MCID for ASES and FF in the MC group. Level of Evidence: Level III, retrospective comparative case series.