Clinical examination. Constant Scoring. Cybex testing of the rotator cuff muscles. MRI scans. Arthroscopic examination followed by arthroscopic SAD. Standard post-op rehab. Tests were repeated at 6 months, and in 17 patients again 3 years after surgery.
SAD still provides good pain relief Muscle power increases post-operative but tends to plateau or slightly decrease after 3 years Dynamic muscle power measurement is recommended for accurate assessment. Other Cybex measurements (Torque) had little relation to clinical outcome. Constant score does not accurately assess changes in muscle power.
All tests were repeated at the minimum of 6 (average 6.3) months after the operation.
CLINICAL
- 23 (95.83%) improved subjectively, and were back to their normal daily routines. - The average improvement in VAS scoring was an average of 3.5 (2–7)) - Impingement signs disappeared in 23 patients (95.83%) - Average increase in Constant score was 23 points, from 53.5 to 76.5.Average pain increased from 7.5 to 9, ADL from 5.5 to 6, hand position from 7 to 8, range of motion from 21.5 to 37 &
power from 9 to 17. Dynamometer Muscle testing (All measurement of power was done in watts)
A-Abduction power increased from an average of 14.5 to 32.9, Adduction from 17 to 42 b- At maximal adduction internal rotators increased from 25.5 to 34.55, external rotators from 20.25 to 30.85 and c- At 90° abduction the internal rotators increased from 19.55 to 31.3, and the external rotators from 16.6 to 21.95
-ASD provides good pain relief -Most patients return to work before the end of 6 months period; however there seems to be a tendency for further improvement after the 6 months period. - Muscle power increases post-operative but with individual variation -Dynamic Power assessment is preferable to the Constant Score method, as power is measured in Watts, and can test below 90° of elevation. -Power measurement is the only parameter directly related to the clinical outcome of ASD.
