Abstract
Rotator cuff pathology is common in orthopaedic patients. However, there are still debates about the best way of treating those patients. We present the clinical experience from our Unit.
We present 85 patients who had arthroscopic or arthroscopically assisted shoulder surgery for full thickness rotator cuff tears between 1994 and 2001. Their medical records and radiological investigations were reviewed, and the management as well as the outcome of their treatment were recorded. The aim was to review those patients and determine if optimum assessment and management was implemented to them.
There were 47 male and 38 female patients with average age 58.8 years and weight 79.9 kg, 32 of the patients reported trauma prior to their symptoms. 63 patients had MRI scan and they had average 2.6 years of symptoms and 2.4 steroid injections before their operative management. 27 patients had arthroscopic and 58 mini open rotator cuff repair. From those with recorded pain management 32 patients had interscalene block and 21 infiltration with local anaesthetic. Their average hospital stay was 1.4 and 1.8 days for the arthroscopic and mini open repairs respectively. In 69 (77.7%) patients the result was considered overall satisfactory; 8 (9.4%) patients had temporary shoulder stiffness and/or pain, which were treated conservatively with steroid injections and physiotherapy. 11 (12.9%) of the patients required reoperation, 5 from which required cuff resuturing and 4 manipulations under anaesthetic for postoperative stiffness. 3 patients (3.5%) had other than shoulder complications including CVA, chest infection, and CTS.
Rotator cuff surgery remains a challenge where often the working surgical plan is altered intraoperatively and tissue quality is of major importance for the final outcome. Arthroscopy has reduced patient’s hospital stay and rehabilitation time. However, a not durable repair, or postoperative stiffness can be a potential risk complicating the surgical result.
In this study it is demonstrated that treatment of patients with rotator cuff disease is still a challenge, time in hospital is reduced with arthroscopic management, but the overall risk for reoperation/MUA either for not durable previous repair or postoperative stiffness was still quite high (12.9%).
These abstracts were prepared by Mr Cormac Kelly. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
