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Objectives and questions: Clinical registries enable standardized outcome assessment and continuous quality improvement in healthcare. The Local Rotator Cuff Registry (RCR) was established as a single-center clinical registry to systematically collect baseline characteristics, imaging findings, surgical details, and patient-reported outcome measures (PROMs). This study describes the registry structure and key variables and analyzes cohort characteristics, PROMs, and data completeness.

Material and methods: The RCR includes all patients who underwent arthroscopic rotator cuff repair between 2010 and 2025. Recorded variables comprise demographics and risk factors, intraoperative tear characteristics (Gerber classification), tendon involvement patterns, and MRI-based fatty infiltration graded according to Goutallier. PROMs included the Subjective Shoulder Value (SSV), Oxford Shoulder Score (OSS), EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) with EQ-VAS and utility index, Constant Score (CS), and pain numeric rating scale (NRS), assessed preoperatively and at 6 and 24 months postoperatively.

Results: A total of 4,915 shoulders were registered (63% male; mean age 58.2 years; mean BMI 26 kg/m²). ASA classification was 22% ASA I, 66% ASA II, 11% ASA III, and <1% ASA IV; 18% of patients were smokers. The operated shoulder was dominant in 67%, and 10% had prior ipsilateral surgery. All procedures were arthroscopic. Biceps management consisted of tenotomy in 15%, tenodesis in 61%, and no intervention in 24%. Tear size distribution was 23% partial tears, 34% full-thickness single-tendon tears, 19% multi-tendon tears, and 25% massive tears; isolated supraspinatus tears were most common (46%). Data completeness was 99% for baseline demographics and 74–78% for preoperative PROMs; 54.4% of questionnaires were completed electronically. Follow-up rates for SSV, OSS, and EQ-5D-5L were 80–89% at 6 months and 69–75% at 24 months. The Constant Score was fully documented at 24 months in <1% of cases. Adverse events were recorded, but follow-up documentation was incomplete. PROMs improved significantly from baseline to follow-up. At 24 months, mean SSV increased from 52.1% to 94.5%, OSS from 28.3 to 43.9, EQ-VAS from 67.7 to 86.0, and EQ-5D-5L utility index from 0.7 to 0.9 (all p < 0.001). Mean pain NRS decreased from 5.6 to 2.1 (p = 0.008). Mean Constant Score improved from 54.2 preoperatively to 73.2 at 6 months (p < 0.001).

Discussion and conclusions: This large single-center registry characterizes the local rotator cuff repair population and demonstrates significant postoperative improvement. However, limitations include incomplete long-term follow-up and adverse event documentation. Future registry optimization should focus on a condensed core outcome set and robust, digitally supported follow-up workflows.