Abstract
Aim: To investigate the effect of Arthroscopic Subacromial Decompression and rehabilitation on rotator cuff muscle strength and function.
Material: 24 patients with primary impingement syndrome and intact rotator cuffs were recruited. 8 further patients were excluded due to pathologies found at arthroscopy.
Methods: All recruited patients prior to surgery underwent: 1- Through clinical examination. 2-Constant Scoring. 3- Detailed Cybex dynamometer testing of the rotator cuff muscles of both shoulders in six different positions with the same range and for power, speed and torque. 4- MRI scans. 5- Full arthroscopic examination followed by a routine arthroscopic SAD. 6-Standard post-op rehab programme.
All tests were repeated at the minimum of 6 (average 6.3) months after the operation.
Results:
CLINICAL
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- 23 (95.83%) improved subjectively, and were back to their normal daily routines.
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- The average improvement in VAS scoring was an average of 3.5 (2–7))
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- Impingement signs disappeared in 23 patients (95.83%)
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- Average increase in Constant score was 23 points, from 53.5 to 76.5.Average pain increased from 7.5 to 9, ADL from 5.5 to 6, hand position from 7 to 8, range of motion from 21.5 to 37 & power from 9 to 17. Dynamometer Muscle testing (All measurement of power was done in watts)
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A-Abduction power increased from an average of 14.5 to 32.9, Adduction from 17 to 42
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b- At maximal adduction internal rotators increased from 25.5 to 34.55, external rotators from 20.25 to 30.85 and
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c- At 90° abduction the internal rotators increased from 19.55 to 31.3, and the external rotators from 16.6 to 21.95
Conclusions:
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-ASD provides good pain relief
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-Most patients return to work before the end of 6 months period; however there seems to be a tendency for further improvement after the 6 months period.
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- Muscle power increases post-operative but with individual variation
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-Dynamic Power assessment is preferable to the Constant Score method, as power is measured in Watts, and can test below 90° of elevation.
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-Power measurement is the only parameter directly related to the clinical outcome of ASD.
The abstracts were prepared by David Stanley. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
