engleski

Long-term results of open rotator cuff repaair

The purpose of this study is to evaluate shoulder function after open rotator cuff repair with minimal follow-up (FU) of 6 years. 166 patients (176 shoulders) with rotator cuff tear were operated between 1992 and 2000 by the senior surgeon. There were 96 male and 70 female patients with an average age of 54 years (range 29-77) at the time of surgery. In all patients open repair was performed. Patients with minimal FU of 6 years were included in the study. Average FU was 9.6 years (range 6-14). Clinical and radiographic evaluation was performed and outcome was compared with various preoperative, intraop. and postop. factors for which correlation analysis was calculated and results were discussed. Preoperative average Constant score (CS) for small rotator cuff tear was 40 points and postoperative was 77 points. Preoperative average CS for medium rotator cuff tear was 39 points and postoperative was 80 points. Preoperative average CS for large rotator cuff tear was 38 points and postoperative was 75 points. Preoperative average CS for massive rotator cuff tear (direct repair) was 36 points and postoperative was 73 points. Preoperative average CS for massive rotator cuff tear (subscapularis tendon transfer) was 35 points and postoperative was 66 points. 95% patients had complete loss of pain or just light pain under load. 77% patients returned to previous job after the surgery. In 7 patients reoperation was needed. Better results were achieved with preserved subacromial distance regardless of tear size (CS: 77 to 68). In majority of patients the most significant improvement was pain relief and greater range of motion. Factors with the greatest influence on the outcome were preoperative ROM, tear size and symptoms duration. For massive cuff tears better results were achieved when direct repair was performed but good pain relief and ROM were also achieved with subscapularis tendon transfer. Therefore we recommend early surgical treatment for patients with rotator cuff tears, especially in younger, physically active patients and direct repair for massive cuff tears whenever possible.

shoulder; open cuff repair

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