FUNCTIONAL AND ANATOMICAL RESULTS AFTER ROTATOR CUFF REPAIR

The anatomic condition of the rotator cuff and the functional results obtained were studied in a homogeneous series of 100 full thickness cu ff tears in 98 patients with an average followup of 4 years. Constant' s functional score, used by the European Society for Shoulder and Elbo w Surgery, was done preoperatively and postoperatively in each patient , in addition to ultrasonography at followup. There was a close correl ation between the anatomic condition of the cuff and Constant's functi onal score before surgery (p 0.0063) and after repair, irrespective of the type of tear repaired (p = 0.0012) or the sonographic appearance of the cuff at followup (p = 0.0001). Ultrasonography showed 65% intac t cuffs, 11% intact but thinned cuffs, and 24% recurrent defects. Thre e predisposing factors for recurrence were noted: size of tear to be r epaired (p = 0.0001) accounted for 57%, age (p = 0.063) for 25%, and d egree of occupational use for 18%. The functional results obtained wer e more related to the anatomic condition of the repaired cuff at follo wup than to the tear size at surgery. Predictive clinical factors for recurrence included overall Constant's functional score, reduced abili ty to perform daily activities, reduced active flexion, abduction and external rotation, and loss of muscular strength. Constant's functiona l score reflected the functional results with accuracy, reliability, a nd reproducibility, Additional ultrasonography appears necessary to sp ecify the exact size of the recurrent defect and to distinguish betwee n certain anatomic types, such as thinned cuffs, which can give rise t o difficult problems in manual workers after defect repair.