Document Detail


Open rotator cuff repair without acromioplasty.
MedLine Citation:
PMID:  15930537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In most clinical reports on rotator cuff repair, acromioplasty was done as part of the procedure. In this prospective study, we evaluated the hypothesis that rotator cuff repair without acromioplasty would result in a substantial improvement in shoulder comfort and function. METHODS: Ninety-six consecutive primary repairs of full-thickness tears of the rotator cuff were performed through a deltoid-muscle-splitting incision that preserved the integrity of the coracoacromial arch and the deltoid insertion. All patients were invited to participate in a prospective study involving periodic self-assessment of shoulder function with the Simple Shoulder Test and general health status with the Short Form-36 (SF-36) questionnaire, both of which are validated instruments. Sixty-one patients provided follow-up information for at least two years postoperatively, and the average duration of follow-up was five years. Thirty-four of the tears involved the supraspinatus tendon alone; sixteen involved the supraspinatus and infraspinatus tendons; and eleven involved the supraspinatus, infraspinatus, and subscapularis tendons. RESULTS: The percentage of shoulders that could be used to perform each of the twelve functions on the Simple Shoulder Test was significantly increased postoperatively (p < 0.002). Men and women had different degrees of function preoperatively (p < 0.00000001) and postoperatively (p < 0.001), but the improvement in function was essentially identical for the two genders. The mean improvement in the number of shoulder tests that could be performed was best for the patients with one-tendon tears (4.9 tests), next best for those with two-tendon tears (3.6 tests), and worst for those with three-tendon tears (3.3 tests). SF-36 scores for physical role (p < 0.003) and comfort (p < 0.0001) were significantly improved postoperatively. CONCLUSIONS: Significant improvement in self-assessed shoulder comfort and in each of the twelve shoulder functions was observed after rotator cuff repairs performed without acromioplasty. The technique that we used is very similar to that described by Codman almost seventy years ago.
Authors:
Wren V McCallister; I Moby Parsons; Robert M Titelman; Frederick A Matsen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  87     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-02     Completed Date:  2005-07-29     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1278-83     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 N.E. Pacific Street, Box 356500, Seattle, WA 98195, USA.
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MeSH Terms
Descriptor/Qualifier:
Acromion / surgery*
Adult
Aged
Female
Health Status Indicators
Humans
Male
Middle Aged
Orthopedic Procedures / methods*
Pain Measurement
Prospective Studies
Range of Motion, Articular
Recovery of Function
Rotator Cuff / injuries*,  surgery*
Shoulder Joint / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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