Patient-reported and clinical outcomes up to 2 years after primary rotator cuff repair: do we need to collect patient-reported outcomes at 2-year follow-up visit?

Background: Rotator cuff repair (RCR) is commonly associated with significant improvements in patient-reported outcomes (PROs) within the first postoperative year. Most journal guidelines typically recommend reporting outcomes at a minimum of 2 years, yet evidence suggests that outcome improvements may plateau after the first year. This study examines the clinical value of extended follow-up by evaluating changes in Single Assessment Numeric Evaluation (SANE) scores between the first- and second-year post-surgery. To determine whether there is a clinically significant improvement in SANE scores between 1 and 2 years after surgery and to assess the sufficiency of a 1-year follow-up for outcome evaluation. It was hypothesized that there would be no clinically significant difference in clinical outcome between the 1- and 2-year time points after primary RCR. Methods: The study included 495 patients who underwent primary RCR within a single health care system between May 1, 2018, and September 30, 2021. Patients with prior shoulder surgery, incomplete PROs, or concomitant shoulder fractures were excluded. Baseline characteristics, surgical details, and PROs were analyzed. SANE scores were measured preoperatively and 1 and 2 years postoperatively. Minimal Clinically Important Difference (MCID) values were determined, and changes in SANE scores were evaluated using statistical analysis, including t-tests and regression models. Results: The mean age of the cohort was 61.5 ± 8.4 years (range: 32-80 years), with 58% male patients. SANE scores significantly improved from baseline (40.8 ± 20.3) to 1 year postoperatively (84.1 ± 19.6, P < .001). The increase from 1 to 2 years (87.5 ± 18.1) was statistically significant (P < .001) but clinically insignificant based on the MCID. At 1 year, 48.1% of the patients met the MCID for SANE, compared to 43.0% at 2 years. Conclusion: The majority of functional and symptomatic improvements following RCR occur within the first year, with minimal clinically meaningful gains observed between 1 and 2 years. This supports the hypothesis and sufficiency of a 1-year PROMs for assessing postoperative outcomes, optimizing resource allocation, and reducing patient burden without compromising clinical insight.