Abstract
Aim: To assess the outcome of arthroscopic subacromial decompression on rotator cuff muscles
Material: 44 patients with impingement syndrome and intact rotator cuffs were recruited 3 years ago. All were followed up 6 months after surgery and 17 were selected randomly to attended after 3 years.
Methods: All patients prior to surgery underwent:
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Clinical examination.
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Constant Scoring.
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Cybex testing of the rotator cuff muscles.
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MRI scans.
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Arthroscopic examination followed by arthroscopic SAD.
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Standard post-op rehab.
Tests were repeated at 6 months, and in 17 patients again 3 years after surgery.
Results: 1– 41patients (93.18%) improved subjectively at 6 months, and 12 (out of 17) were still satisfied after3 years. 3- Impingement signs disappeared in 41 patients at 6 months and in 13 out of 17 at three years. 4- Average increase in Constant score was 18 points at 6 months and 4 points at 3 years. Pain ADL Pos. ROM Power Total Pre-op mean 5.71 5.23 5.23 25.45 8.76 50.38 Post-op mean 11.67 8.04 8.14 38.05 20.9 86.8 3 years mean 10.91 8.02 7.83 42.78 16.6 86.14 5-Dynamometer (Cybex) Muscle testing: Average power in Watts Abduct Adduct Int. Rot. Ext. Rot. Int. Rot. Ext. Rotation at side at side at 90abduct at 90abduct Pre-op 40.01 61.3 38.2 23.12 32.56 27.78 6/12 postop 54.78 76.6 51.93 36.34 40.74 39.19 3 years p.o. 52.65 69.98 52.77 38.55 40.78 36.21
Conclusions
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SAD still provides good pain relief
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Muscle power increases post-operative but tends to plateau or slightly decrease after 3 years
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Dynamic muscle power measurement is recommended for accurate assessment.
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Other Cybex measurements (Torque) had little relation to clinical outcome.
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Constant score does not accurately assess changes in muscle power.
The abstracts were prepared by Cormac Kelly. Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
