PARTIAL AND FULL-THICKNESS ROTATOR CUFF TEARS: RANGE OF MOTION COMPARISON

Abstract

Purpose: The purpose of this historical prospective study was to compare the pre and post-operative range of motion (ROM) and quality of life outcomes 6 months post-operatively in patients with partial and full-thickness tears of the rotator cuff.

Methods: Data of 90 consecutive patients diagnosed with partial thickness tear (PTT) who had undergone decompression and or acromiploasty were compared with 90 patients (age and gender-matched) who had undergone repair of a full-thickness tear (FTT). The outcomes were objective pre and post-operative range of motion (ROM) in 5 directions and three patient-derived outcome measures; one disease-specific, the Western Ontario Rotator Cuff Index, and two shoulder specific measures: the American Shoulder & Elbow Surgeons standardized shoulder assessment form and, the Constant-Murley. A statistical paired t-test analysis was conducted between change (pre vs. 6 months) in ROM and QOL scores to examine the impact of severity on improvement between the 2 groups.

Results: Forty-three females and 47 males in each group (180 subjects in total) were included in the analysis. The mean age was 54.8 and 54.9 for the PTT and FTT groups respectively. The PTT group was significantly stiffer in pre-operative passive flexion (p=0.010), abduction (p=0.022) and active external rotation at 0 degree of abduction (p=0.040). The 6-month WORC, ASES, and relative Constant all showed significant improvement in quality of life in both groups (p< 0.0001). There was a statistically significant difference in passive external rotation at 0 degrees of abduction between groups with FTT group being stiffer than the PTT group (p=0.019) post-operatively. Change in ROM was not significantly different in all other directions.

Conclusions: The intent of this study was to compare the pre-operative and rate of improvement in two groups of patients suffering from different severity of pathology. The results indicate that quality of life improves significantly regardless of the extent of tear (partial thickness vs. full thickness). Patients with FTT may require a longer time to improve their range of motion in external rotation.