Comparison of Patient Outcomes and Re-tear Rates in Rotator Cuff Repair with Mechanical Alone versus Mechanical Plus Coblation Debridement: A Prospective Randomized Controlled Trial

Background One of the most common complications following arthroscopic rotator cuff repair is non-healing or re-tearing of the rotator cuff. The purpose of this study was to evaluate clinical and anatomic outcomes of patients randomized to either mechanical debridement alone, or mechanical plus coblation debridement of the humeral footprint, during rotator cuff repair. Methods This single-blind, randomized trial included patients with full-thickness rotator cuff tears. Upon confirming a reparable tear intra-operatively, patients were randomly assigned to either mechanical debridement alone, or mechanical plus coblation debridement, of the humeral footprint following a standardized protocol. Patients underwent a standardized post-operative rehabilitation protocol, completed clinical outcomes at 3-, 6-, and 12-months, and underwent a post-operative MRI at 12-months. Results 92 patients were enrolled in the study. WORC scores improved significantly from baseline to 12-month follow-up (p < 0.001) and were not different between groups (p = 0.26). Thirty-three percent of patients had evidence of a re-tear on the 12-month MRI, however the rate of re-tears was not different between groups (p = 0.253). Pre-operative Patte classification (p = 0.011) and Goutallier grading (p = 0.041), both correlated significantly with worse post-operative tendon integrity. Coblation debridement was significantly faster than mechanical debridement alone (p < 0.001) despite overall comparable surgical times (p = 0.90). Conclusion Mechanical plus coblation debridement is a significantly faster technique than mechanical debridement alone, and yields similar clinical and anatomic outcomes.