Abstract
Purpose
The purpose of this study was to investigate the difference in the level of pre- and 6 months post-operative objective and subjective measures of disability between patients with full-thickness rotator cuff tears and those with impingement syndrome/low grade partial thickness rotator cuff tears. Impact of age, gender, and job demands was taken into consideration.
Methods
Standardised pre- and post-operative data were collected on consecutive patients who had undergone surgery related to rotator cuff pathology. A disease-specific disability measure, the Western Ontario Rotator Cuff (WORC) Index which explores five domains of physical symptoms – life style, work, sports, and emotions – was the primary outcome. Paired and independent non-parametric statistics and multivariable regression analysis were performed.
Results
Three hundred and thirty patients (140 women and 190 men) with a mean age of 58 years (range, 21-82) met the inclusion criteria. Two hundred and fifteen (65%) patients had full-thickness rotator cuff tears and 115 (35%) had impingement or partial thickness rotator cuff tears. Patients with full-thickness tears complained of greater weakness and had a higher prevalence of a fall on an outstretched hand. They were significantly weaker in elevation both pre- (p=0.0002) and post-operatively (< 0.0001). Patients with impingement syndrome expressed more emotional disability both prior to (0.007) and after surgery (0.004). Both groups showed a statistically significant improvement in overall pain, disability and strength 6 months following surgery (p< 0.0001). Factors that affected emotional disability at both time points were job demands and age. Females were more emotionally disabled before surgery.
Conclusion
Patients with impingement syndrome and less extensive tears tend to be more emotionally disabled due to their gender, age and work status/job demands. This needs to be considered when planning for return to work and other activities and when assessing treatment outcomes.
