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.

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.

The purpose of this study was to examine clinical outcomes of capsular plication using subjective outcome measures and objective clinical examination with emphasis on range of motion. Data of consecutive patients (twenty-five at six months and twenty at twelve months) who required arthroscopic stabilization over a period of three years were retrospectively reviewed. At six and twelve month post-operatively, the disease specific outcome measure, ASES, and relative Constant, showed significant changes in quality of life. There was no loss of external rotation at 0° and 90° of external rotation at one year post-operatively.

The purpose of this study was firstly to assess the effectiveness of capsular plication, in the treatment of instability related pathology, using subjective outcome measures and secondly to look specifically at the effect of this procedure on range of motion.

Suture capsular plication has been advocated as a less invasive technique to reduce symptomatic capsular laxity with less morbidity than traditional open techniques. There is, however, little evidence that this procedure has the same clinical effectiveness as open capsular shift procedures.

Arthroscopic capsular plication improves quality of life (QOL) in patients suffering from shoulder instability without significantly restricting external rotation.

Data of consecutive patients who required arthroscopic stabilization over a period of three years were retrospectively reviewed. Three outcome measures were used; one disease-specific and two shoulder specific measures:

the American Shoulder & Elbow Surgeons standardized shoulder assessment form and,

Analysis involved a paired T test between the means of each outcome measure pre and post-surgery.

Twenty-five patients had complete pre-op and six- month post-op data. Twenty subjects had complete pre-op and twelve- month post-op data. At six month post-operatively, the disease specific outcome, relative Constant, and ASES showed significant improvement in QOL scores (P< 0.000, 0.006, and, 0.004 respectively). At twelve- month post surgery, change in all measures remained statistically significant. There was no loss of range of motion in external rotation at 0° or 90° of abduction between initial and follow up assessments in the clinic.

Funding: This study was supported by the research funds of the Orthopedic & Arthritic Institute, Sunnybrook and Women’s College Health Sciences Centre.

Purpose: Purpose: Prognostic factors for a satisfactory result for repaired tears have been postulated to include patient age and size of tear. The purpose of this study was to examine the impact of rotator cuff tear size on pre-operative and 2 year post-operative perceived functional level of patients undergoing repair of the full-thickness tear.

Methods: Methods: Data of 88 consecutive patients were included in data analysis. Patients were categorized into two groups: small or moderate tear (SMT) group, and large or massive tear (LMT) group. Two self-report measures - the Western Ontario Rotator Cuff Index (WORC), and the American Shoulder and Elbow Surgeons (ASES) evaluation form - were used to examine disability at baseline, and two years after surgery for repair of the rotator cuff. The Constant Murley (CM), which evaluates range of motion, strength and self-report function, was also used at the two time periods. A two-way, repeated measures analysis of co-variance (ANCOVA) compared the two groups across the two times. Covariates were age and gender.

Results: Results: Fifty-two patients (mean age = 56.6±10.4) had small or moderate and 36 (mean age = 66.7±11.3) had large or massive full-thickness tears. The results of all measures at both time periods demonstrated poorer function for the LMT group (pre WORC 31.4, post WORC 59.0; pre ASES 37.0, post ASES 65.0; pre CM 49.3, post CM 69.6) compared to the SMT group (pre WORC 38.2, post WORC 67.2; pre ASES 43.4, post ASES 73.8; pre CM 55.3, post CM 80.7). Both groups had improved function at 2 years post-operatively, but the rate of change was similar in the two groups.

Conclusions: Conclusion: The results of this study indicate that the size of a full-thickness tear of the rotator cuff has an effect on shoulder function both pre and postoperatively, but not on the pattern of recovery.