Friday, January 8, 2016

Rotator cuff repair - what is the retear rate and does a retear affect the clinical outcome?

Early postoperative repair status after rotator cuff repair cannot be accurately classified using questionnaires of patient function and isokinetic strength evaluation.

These authors sought to determine whether the clinical condition of shoulders 16 weeks after arthroscopic supraspinatus repair was affected by the integrity of the repair. 

In 60 patients they compared the Sugaya MRI rotator cuff classification system for cuff integrity to the Oxford Shoulder Score, 11-item version of the Disabilities of the Arm, Shoulder and Hand, visual analog scale for pain, 12-item Short Form Health Survey, and isokinetic strength. 

64% of the repairs had retears 4 months after surgery. They found no differences in the clinical or strength measures between intact repairs (Sugaya grade 1) and partial-thickness retears (Sugaya grades 2 and 3).

Comment: So, once again, we see (1) a very high rate of failure of rotator cuff surgery to durably restore the integrity of the cuff and (2) a lack of correlation between cuff integrity and clinical outcome.

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