Relationship between clinical and surgical findings and reparability of large and massive rotator cuff tears: a longitudinal study

BMC Musculoskeletal Disorders

Helen Razmjou¹  Richard Holtby² 

[1] Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada;Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada

关键词: Predictors;    Partial repair;    Rotator cuff tear;    Massive;    Large;   

Others  :  1125656
DOI  :  10.1186/1471-2474-15-180

 received in 2013-12-13, accepted in 2014-05-21,  发布年份 2014

【 摘 要 】

Background

The literature has shown good results with partial repairs of large and massive tears of rotator cuff but the role of factors that affect reparability is less clear. The purpose of this study was twofold, 1) to examine clinical outcomes following complete or partial repair of large or massive full-thickness rotator cuff tear, and 2) to explore the value of clinical and surgical factors in predicting reparability.

Methods

This was a secondary data analysis of consecutive patients with large or massive rotator cuff tear who required surgical treatment (arthroscopic complete or partial repair) and were followed up for two years. Disability measures included the American Shoulder and Elbow Surgeons (ASES), the relative Constant-Murley score (CMS) and the shortened version of the Western Ontario Rotator Cuff Index (ShortWORC). The relationship between predictors and reparability was examined through logistic regressions and chi-square statistics as appropriate. Within group change over time and between group differences in disability outcomes, range of motion and strength were examined by student’s T-tests and non-parametric statistics.

Results

One hundred and twenty two patients (41 women, 81 men, mean age 64, SD = 9) were included in the analysis. There were 86 large (39 fully reparable, 47 partially reparable) and 36 (10 fully reparable, 26 partially reparable) massive tears. Reparability was not associated with age, sex, or pre-operative active flexion or abduction (p > 0.05) but the fully reparable tear group showed a better pre-operative ASES score (p = 0.01) and better active external rotation in neutral (p = 0.01). Reparability was associated with tear shape (p < 0.0001), size (p = 0.002), and tendon quality (p < 0.0001).

Conclusions

Reparability of large or massive tears is affected by a number of clinical and surgical factors. Patients whose tears could not be fully repaired showed a statistically significant improvement in range of motion, strength and disability at 2 years, although they had slightly inferior results compared to those with complete repairs.

【 授权许可】

   
2014 Holtby and Razmjou; licensee BioMed Central Ltd.

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