Tuesday, July 28, 2015

Results of attempted arthroscopic cuff repair - do articles like this make us any smarter?

Prognostic factors for recovery after arthroscopic rotator cuff repair: a prognostic study

These authors studied a series of 30 patients having attempted arthroscopic rotator cuff repair using the Western Ontario Rotator Cuff Index as primary outcome and RAND-36, Constant-Murley score, and a shoulder hindrance score as secondary outcomes. The characteristics of the rotator cuffs are shown below

Patients were significantly improved at 3 months and 6 months after arthroscopic rotator cuff repair. In multiple regression analysis, no factors could be identified as prognostic of the quality of life after arthroscopic rotator cuff repair (measured with the Western Ontario Rotator Cuff Index). For the outcome variables RAND-36 (6 months, 1 year) and shoulder hindrance score (1 year), fatty infiltration Goutallier stages 1 and 2 and retraction grades II, III, and IV were significant predictors.

What can be learned from this small series is that the recovery after attempted cuff repair is progressive over the first year, with only 50% of the functional recovery having been achieved at 3 months. This is important in light of the article that assumed that workers would be back to work 28 days after attempted cuff repair.

In this study, no followup cuff imaging was performed, so the rate of failure of the repair and the relationship of repair failure to clinical outcome are unknown. 

A comprehensive analysis on the effect of prognostic factors on clinical outcomes and cuff integrity is discussed in this post.


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