Rotator cuff repair. Long-term results

Objectives. - To evaluate the results of rotator cuff repair and to look for preoperative and/or intraoperative predictors of long-term outcomes. Patients and methods. - All patients who underwent open rotator cuff repair surgery for a full-thickness tear between 1990 and 1996 and who were subsequently followed-up for at least 4 years were contacted. The surgical technique and postoperative rehabilitation program were standardized. We recorded factors potentially associated with outcomes (age, sex, dominant hand, pain, symptom duration, and active range-of-motion limitation). Results. - Of the 56 patients identified, 26 men and 24 women with a mean age of 58.52 years were included in the study. Mean symptom duration was 12 months (range, 3-48 months). Before surgery, mean active range of motion of the shoulder was 144.6degrees for forward elevation, 135.2degrees for abduction, and 39.4degrees for lateral rotation with the elbow at the side. The size of the tear measured during surgery was 1-5 cm. Mean time to recovery of shoulder power (75% of the value before the tear) as assessed by the patients was 10 months. After a mean follow-up of 6 years. a significant reduction in pain was noted (from 2.18/3 to 0.98/3; P < 0.001), although two-thirds of the patients reported occasional pain. Six patients were dissatisfied. Range of motion had improved in one-fourth of the patients. Constant's score after surgery was 65/100. Persistent difficulty in taking objects down from high shelves was noted. None of the preoperative or intraoperative factors studied predicted the long-term outcomes. Conclusion. - In this series of patients, rotator cuff repair reduced pain severity. Nearly a year was needed to achieve the final result. Only a minority of patients experienced an improvement in range of motion. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.