Abstract
Purpose: In this retrospective study we have analysed the effect of retears and muscle-malfunction on the results of the repair of 90 massive rotator cuff tears (MRCT) with a minimum follow-up of 2 years.
Materials: We reviewed 90 patients (15F,75M) with 90 massive rotator cuff tear repairs (66R, 24L). The age at surgery was 59 (45–75) years, follow-up 49 (24–134) months. 53 patients had a direct repair and transosseus fixation, 33 patients a local tendon transfer, and 4 a delta-flap. Beside clinical assessement, and evaluation of the Constant-Score, a standarised dynamic and static ultrasound examination of the rotator cuff, SSP and ISP with their kinematic contraction patterns, was performed.
Results: 51.1% rated their result as excellent, 28.9% as good, 11.1% as moderate, 5.6% as fair and 3.3% as poor. The unadapted Constant-score was 68.5 (contralateral 75.8). 61.1% had an ultrasonographically intact cuff reconstruction, 27.8% had a small retear and 12.2% had a retear > 2cm. The Constant-score of patients with an intact reconstruction was 71.6, with large retears 59.7 and with small retears 64.3. Patients with normal Type I contraction patterns of SSP and ISP had a Constant-score of 78.3 and 74.8, whereas those with a type III (little contraction) had 54.9 and 53.1.
Conclusions: 80% good and excellent subjective results show an appropriate treatment of MRCT’s. Because of the significant influence (p< 0,03) of muscle-malfunction, a preoperative ultrasonography of the rotator cuff muscles is performed to assess the muscle function and determine the indication for a muscle transfer.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
