Abstract
Purpose: Does the postoperative abduction brace facilitate healing after rotator cuff repair? We have answered this question empirically using, since 1995, a premodelled abduction brace for four weeks for all patients, together with early passive rehabilitation. The purpose of this work was to assess the efficacy of this brace and compare outcome with that in patients treated in 1994–1995 with and without the brace.
Material and methods: This retrospective analysis was conducted in 72 patients, mean age 58 years. Contant functional score and imaging of the tendon healing (arthroscan 56%, MRI 44%) were used as assessment criteria. Four homogeneous groups were identified: Group 1 (40 patients, mean age 55 years) was composed of patients with a distal tear of the supraspinatus; twenty patients in this group were treated with a “elbow-to-body” sling (group 1a) and twenty others with the abduction brace (group 1b); Group 2 (32 patients, mean age 60 years) was composed of patients with an intermediary tear of the supraspinatus, partially extending anteriorly or posteriorly, fifteen patients in this group were treated with a “elbow-to-body” sling (group 2a) and seventeen others with the abduction brace (group 2b).
Results: Mean follow-up was 49 months. The weighted Constant score improved from 57.3% to 89.1%. Imaging demonstrated recurrent tears in 25 patients (35%). In group 1 (distal tear of the supraspinatus), the weighted Constant score at last follow-up was 89% (93% in group 1a and 86% in group 1b). There were eight recurrent tears (20%), (25% in group 1a and 15% in group 1b). Use of the abduction brace (group 1a) had no effect. In group 2 (intermediat tear of the supraspinatus), weighted Constant score was 88% (82% in group 2a and 94% in group 2b). There were seventeen recurrent tears (53%) (71% in group 2a and 41% in group 2b). At last follow-up, there was no significant difference for functional score or tear recurrence.
Discussion and conclusion: These findings suggest the postoperative abduction brace is not beneficial after repair of non-retracted distal cuff tears. On the contrary, for intermediate tears, it allows a clear improvement in the final Constant score and a lower rate of recurrent tears. This study provides information useful for choosing the postoperative management of patients undergoing repair of rotator cuff tears.
The abstracts were prepared by Pr. Jean-Pierre Courpied (General Secretary). Correspondence should be addressed to him at SOFCOT, 56 rue Boissonade, 75014 Paris, France
