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Full thickness rotator cuff tears long-term follow-up

  • S. Jacobs
  • H. Williams
  • J. Moir
  • B. Welsh
  • R. P. Welch
Original Articles
  • 36 Downloads

Summary

Over a 10 year period, 200 rotator cuff repairs (190 patients) have been performed by the senior author (RPW).

Among the 159 patients who could be located, 90 sent back a questionnaire with the simple shoulder test. 55 patients underwent two shoulder scoring systems (Constant and UCLA scores), ultrasound evaluation an radiographs of both shoulders at a mean follow-up of 13.1 years. The mean Constants and UCLA scores of the operated an unoperated shoulder fell within a range that one might consider as a “good” result. SST results were also equivalent for both shoulders. A analysis of variance examined as many prognostic factors as possible. None of these pre and intra-operative findings proved statistically significant in influencing the longterm out come. Only the status of the cuff at follow-up as evaluated by ultrasound was statistically significant (p=.0277). A Chi-square test was conducted comparing the ultrasound result and the distance measured on radiographs between the humeral head and the acromion. A positive correlation was found (p=.015) which implies that not only ultrasound examination but also an adequate distance between the humeral head and acromion has favourable prognostic value.

Key words

Shoulder Rotator cuff tear Long term follow-up 

Ruptures transfixiantes des rotateurs des coiffes: suivi à long terme

Résumé

Sur une période de 10 ans, 200 ruptures transfixiantes de la coiffe (190 patients) ont été opérées par le même chirurgien (R.P.W.). Parmi les 159 patients lesquels ont été localisés, 90 nous ont renvoyé un questionnaire avec le simple shoulder test. 55 malades ont été examinés en mesurant le score de Constant, le score de UCLA combinés avec une échographie et radiographie des deux épaules. Le recul moyen est de 13,1 années. Les valeurs pour les scores de Constant et UCLA peuvent être considérées comme un bon résultat. Une analyse uni-variée (ANOVA) a permis d’examiner la plupart des facteurs déterminants. Aucun des facteurs pré et per opératoires n’a une importante significative concernant le résultat à long terme. Seulement l’état de la coiffe à l’échographie était statistiquement signifiant (p=.0277). Une analyse multivariée a pu comparer les résultats échographiques par rapport à la distance entre la tête humérale et l’acromion. Ceci a donné une corrélation positive (p=.015) ce qui implique que les résultats échographiques mais aussi la distance acromio-humérale ont une valeur pronostique.

Mot clés

Rupture de la coiffe des rotateurs Epaule 

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References

  1. 1.
    Adamson GJ, Tibone JE (1993) Ten-year assessment of primary rotator cuff repairs. J Shoulder Elbow Surg 2: 57–63CrossRefGoogle Scholar
  2. 2.
    Bakalim G, Pasila M (1975) Surgical treatment of rupture of the rotator cuff tendon. Acta Orthop Scand 46: 751–757PubMedCrossRefGoogle Scholar
  3. 3.
    Bassett R, Cofield R (1983) Acute tears of the rotator cuff: The timing of the surgical repair. Clin Orthop 175: 18–24PubMedGoogle Scholar
  4. 4.
    Biglianni LU, Condasco FA et al. (1992) Operative repair of massive rotator cuff tears: longterm results. J Shoulder Elbow Surg 1: 120–130Google Scholar
  5. 5.
    Calvert PT, Packer ND, Stoker DJ et al. (1986) Arthrography of the shoulder after operative repair of the torn rotator cuff. J Bone Joint Surg 68 (B): 147–150Google Scholar
  6. 6.
    Codman EA (1911) Complete rupture of the supraspinatus tendon. Operative treatment with report of two successful cases. Boston Med Surg J 164: 708–710Google Scholar
  7. 7.
    Cofield RH (1982) Subscapular muscle transposition for repair of chronic rotator cuff tears. Surg Gynecol Obstet 754: 667–672.Google Scholar
  8. 8.
    Constant C (1990) Shoulder functions after rotator cuff tears treated by operative and nonoperative means. In Post M, Money B, Hawkins R (eds): Surgery of the Shoulder, St Louis, Mosby Year Book, pp 231–233Google Scholar
  9. 9.
    Cordasco FA, Biglianni LU (1997) The Rotator Cuff, Large and massive tears technique of open repair. Orthop Clin North Am 28 (2): 179–193PubMedCrossRefGoogle Scholar
  10. 10.
    Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff: End result study of factors influencing reconstruction. J Bone Joint Surg 68 (A): 1136–1144PubMedGoogle Scholar
  11. 11.
    Gazielly DF, Gleyze P, Montagnon C (1994) Functional and anatomical results after rotator cuff repair. Clin Orthop 304: 43–53PubMedGoogle Scholar
  12. 12.
    Gerber C, Vinh TS, Hertel R, Hess CW (1988) Latissimus dorsi transfer for the treatment of massive tears of the rotator cuff. Clin Orthop 232: 51–61PubMedGoogle Scholar
  13. 13.
    Gore D. et al. (1986) Shoulder-muscle strength and range of motion following surgical repair of full-thickness rotator cuff tears. J Bone Joint Surg 68 (A): 266–272PubMedGoogle Scholar
  14. 14.
    Goutallier D, Postel JM, Bernageau J et al. (1994) Fatty muscle degeneration in cuff ruptures pre-and post operative evaluation by CT Scan. Clin Orthop 304: 78–83PubMedGoogle Scholar
  15. 15.
    Gupta et al. (1997) Results of surgical repair of full thickness tears of the rotator cuff. Orthop Clin North Am 28(2): 241–248.PubMedCrossRefGoogle Scholar
  16. 16.
    Harrymann D et al. (1991) Repairs of the rotator cuff: Correlation of functional results with integrity of the cuff. J Bone Joint Surg 73 (A): 982–989Google Scholar
  17. 17.
    Hartsell HD (1993) Post-surgical shoulder strength in the older patient. J Orthop Sports Phys Ther, Dec. 18 (6): 667–672PubMedGoogle Scholar
  18. 18.
    Hawkins R, Misamore G, Hobeika P (1985) Surgery for full-thickness rotator cuff tears. J Bone Joint Surg 67 (A): 1349–1355PubMedGoogle Scholar
  19. 19.
    Ianotti JP et al. (1996) Post-operative assessment of shoulder function. A prospective study of full-thickness rotator cuff tears. J Shoulder Elbow Surg, Nov. 5(6): 449–457CrossRefGoogle Scholar
  20. 20.
    Kronber M, Worhlstrom P, Brostrom LA (1997) Shoulder function after surgical repair of rotator cuff tears. J Shoulder Elbow Surg, Mar 6 (2): 125–130CrossRefGoogle Scholar
  21. 21.
    McLaughlin HL (1963) Repair of major cuff ruptures. Surg Clin North Am 43: 1535–1540PubMedGoogle Scholar
  22. 22.
    Nasca RJ (1984) Surgical treatment of rotator cuff tears, in Surgery of the Shoulder: Toronto, CV Mosby Co., pp 149–153Google Scholar
  23. 23.
    Neer CS II (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg 54 (A): 41–50PubMedGoogle Scholar
  24. 24.
    Neer CS II, Flatow E, Lech O (1988) Tears of the Rotator Cuff, Long term results of anterior acromioplaty and repair. Orthop Trans 12 (3): 673–674Google Scholar
  25. 25.
    Neviaser JS et al. (1978) The repair of chronic massive ruptures of the rotator cuff of the shoulder by use of a Free-Dried rotator cuff. J Bone Joint Surg. 60 (A): 681–684PubMedGoogle Scholar
  26. 26.
    Noubuhara K et al. (1994) Surgical procedure and results of repair of massive tears of the rotator cuff. Clin Orthop 304: 54–59Google Scholar
  27. 27.
    Ozaki J. et al. (1989) Reconstruction of chronic massive rotator cuff tears with synthetic materials. Clin Orthop 202: 173–183Google Scholar
  28. 28.
    Packer ND, Calvert PT, Bayley J et al. (1983) Operative treatment of chronic ruptures of the rotator cuff of the shoulder. J. Bone Joint Surg 65 (B): 171–175Google Scholar
  29. 29.
    Rockwood CA, Matsen FA (1990) The shoulder. WB Saunders Co., Vol 2, Chapter 15, pp 638–642Google Scholar
  30. 30.
    Watson M (1985) Major ruptures of the rotator cuff. The results of surgical repair in 89 patients. J Bone Joint Surg 67 (B): 618–624Google Scholar
  31. 31.
    Wolfang G (1974) Surgical repairs of tears of the rotator cuff of the shoulder. Factor influencing the result. J Bone Joint Surg 65 (A): 14–25Google Scholar

Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • S. Jacobs
    • 1
  • H. Williams
    • 2
  • J. Moir
    • 2
  • B. Welsh
    • 2
  • R. P. Welch
    • 2
  1. 1.Service d’OrthopédiePolyclinique des Portes du JuraMontbéliardFrance
  2. 2.Orthopaedic and Arthritic HospitalUniversity of TorontoTorontoCanada

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