Results of a second attempt at surgical repair of a failed initial rotator-cuff repair.

Background Several studies have reported functional recovery of the shoulder after arthroscopic rotator cuff repair (ARCR). Preoperative estimation of the time required for functional recovery is important for determining surgical indications and for planning timing of the surgery and an appropriate postoperative physical therapy. Questions/purposes We therefore asked: (1) how long it takes to obtain functional recovery after ARCR, and (2) what preoperative factors influence functional recovery time. Patients and Methods We retrospectively evaluated 201 patients who had undergone ARCR. Using the Japanese Orthopaedic Association (JOA) shoulder scoring system, we defined the functional recovery period as the time required to achieve a score greater than 80% in each component. We evaluated the functional recovery periods and assessed preoperative influencing factors such as age, gender, shoulder stiffness, morphologic features of rotator cuff tears, and rotator cuff tear size. Results Sixty-three patients (31%) took less than 3 months, 81 patients (40%) took between 3 and 6 months, and 57 patients (28%) took greater than 6 months to achieve a score greater than 80% in each JOA shoulder assessment component. Younger patients without shoulder stiffness and with smaller rotator cuff tears had shorter functional recovery periods. Conclusions One hundred forty-four patients (72%) obtained functional recovery within 6 months after ARCR. Age, shoulder stiffness, and rotator cuff tear size influenced functional recovery time.

Section: Methodsmentioning

confidence: 46%

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Manaka

Ito

Matsumoto

et al. 2011

“…The senior author performed a thorough diagnostic evaluation of the glenohumeral joint, including inspection for rotator cuff and labrum abnormalities. Rotator cuff tears of the supraspinatus were stratified by severity by noting whether they were partial or full thickness [8]. The rotator cuff tears were not débrided until the site had been inspected for cuffglenoid contact.…”

Section: Methodsmentioning

confidence: 99%

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Jia

Pannirselvam

et al. 2011

Background One possible cause of shoulder pain is rotator cuff contact with the superior glenoid (cuff-glenoid contact) with the arm in flexion, as occurs during a Neer impingement sign. It has been assumed that the pain with a Neer impingement sign on physical examination of the shoulder was secondary to the rotator cuff making contact with the anterior and lateral acromion. Questions/purposes We determined if the arm position where pain occurs with a Neer impingement sign would correlate with the position where the rotator cuff made contact with the superior glenoid, as determined by arthroscopic evaluation. Patients and Methods We prospectively studied 398 consecutive patients with a positive Neer impingement sign during office examination and used a handheld goniometer to measure (in degrees of flexion) the arm position in which impingement pain occurred. During subsequent arthroscopy, the arm was moved into a similar position, and we measured the arm's position in flexion at the point the rotator cuff made contact with the superior glenoid using a handheld goniometer. We compared the degrees of flexion at which pain occurred preoperatively and at which there was cuff-glenoid contact.

“…Rotator cuff tear size was based on the ASES classification (small, 0-10 mm; medium, 11-30 mm; large, 31-49 mm; massive, [ 50 mm) [9]. Tear size was measured intraoperatively along the anteroposterior base (length) and the widest mediolateral aspect (retraction) using a flexible ruler or a probe tip with millimeter markings.…”

Section: Methodsmentioning

confidence: 99%

Do Outcomes Differ after Rotator Cuff Repair for Patients Receiving Workers' Compensation?

Balyk

Luciak-Corea²,

Otto

et al. 2008

Comparisons of outcomes after rotator cuff repair between Worker's Compensation Board (WCB) recipients and nonrecipients generally do not consider patient, injury, and shoulder characteristics. We compared preoperative differences between WCB recipients and nonrecipients and determined the impact on their 6-month postoperative outcome. We evaluated a prospective cohort of 141 patients with full-thickness rotator cuff tears, 36 of whom (26%) were WCB recipients, preoperatively and 3 and 6 months after rotator cuff repair. Their mean age was 54.0 ± 10.4 years (standard deviation) and 102 (72%) patients were male. Shoulder range of motion, Western Ontario Rotator Cuff (WORC) index, and American Shoulder and Elbow Surgeons' score were used to evaluate outcomes. We performed regression analyses to control for baseline differences in age, baseline scores, smoking status, symptom duration, injury type, and associated biceps disorder between WCB recipients and nonrecipients. WCB recipients were younger and more likely to smoke, have a traumatic injury, and undergo surgery within 6 months of injury. WCB recipients had lower recovery for all outcomes when these differences were not considered but when differences were accounted for, only 6-month WORC scores were lower in WCB recipients. Clinicians should consider preoperative characteristics before concluding WCB recipients experience less recovery after surgical repair.