DIFFERENCE IN OUTCOME BETWEEN BURSAL AND ARTICULAR PARTIAL THICKNESS TEARS: A ONE-YEAR FOLLOWUP RESULTS

Abstract

Purpose: The purpose of this historical prospective study was to compare the pre- and post-operative Quality of Life (QOL) outcomes 12 months post-operatively between Articular Tears (AT) and Bursal Tears (BT) of patients with partial thickness tear of the rotator cuff

Methods: Data of 93 consecutive patients diagnosed with Partial Thickness Tear (PTT) who had undergone decompression, acromiploasty, or repair were used to compare outcome between patients with Articular Tears and Bursal Tears. The QOL outcome measures included one disease specific outcome measure, the Western Ontario Rotator Cuff Index (WORC) and two shoulder specific measures, the American Shoulder & Elbow Surgeons standardized shoulder assessment form (ASES) and the Constant-Murley score. A statistical paired t-test (pre vs. 12 months) and an independent t-test analysis (Articular vs. Bursal) were conducted to examine the impact of the tear site.

Results: Forty-four Articular and 49 Bursal tears (48 females and 45 males) were included in the analysis. The mean age was 55.5 (SD: 13) and 53.3 (SD: 12) for the AT and BT groups respectively. There was no statistically significant difference between two groups in pre-operative QOL outcome scores. Both groups showed significant improvement in the above outcomes (p< 0.0001) one year following surgery. However, the AT group was significantly less improved than the BT group in the ASES scores (p=0.005), and Constant-Murley scores (p=0.035). The WORC was not sensitive in differentiating between the two groups (p=0.11).

Conclusion: The intent of this study was to compare the pre-operative and rate of improvement in two groups of patients suffering from different site of rotator cuff pathology. The results indicate that the quality of life improves significantly regardless of the tear site. The pattern of recovery however is different indicating that patients with Bursal tear show a higher degree of improvement in their functional measures, possibly due to reduced mechanical compression on rotator cuff.