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From * Montana Orthopedics and Sports Medicine, St. Vincent’s Hospital, Billings, Montana, Columbus Bone, Joint and Hand Surgeons, Inc, Columbus, Ohio, the Leni & Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, New York, and Miller Orthopedic Clinic, Shelby, North Carolina
|| Address correspondence to Evan L. Flatow, MD, Department of Orthopaedics, 5 East 98th Street, Box 1188, New York, NY 10029 (e-mail: Eflatow{at}aol.com).
Background: Open rotator cuff repairs have led to excellent clinical results; however, several studies have linked postoperative structural integrity to patient outcomes. The purpose of this study is to prospectively assess postoperative cuff integrity after open rotator cuff repair and assess its relationship to clinical outcome.
Hypothesis: Preoperative rotator cuff tear size and postoperative rotator cuff integrity are important factors in overall clinical outcomes.
Study Design: Prospective nonrandomized clinical outcomes study.
Methods: Forty-seven consecutive patients undergoing repair of full-thickness rotator cuff tears by a single surgeon were enrolled in this prospective study. A standardized evaluation was performed preoperatively and postoperatively at annual intervals. All patients underwent postoperative magnetic resonance imaging at least 1 year after surgery. Statistical evaluation was performed using paired and unpaired 2-tailed t tests for comparison.
Results: Thirty-two patients were available for evaluation. Overall, the patients experienced a significant (P < .05) improvement in their American Shoulder and Elbow Surgeons survey (40–85) and Constant (53–80) scores. The overall retear rate was 31%. Although patients with large tears preoperatively and retears postoperatively had lower overall outcomes scores, this was not significant.
Conclusion: These data support open rotator cuff repair as an effective technique that restores excellent shoulder function. The authors did not find postoperative cuff integrity to have a significant effect on outcomes when compared with those with an intact cuff. In fact, those with a retear still had a significant improvement in all clinical areas assessed, including strength.
Key Words: rotator cuff • open repair • magnetic resonance imaging (MRI) • repair integrity
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