AN ANALYSIS OF ROTATOR CUFF REPAIR

Fifty-four patients who had surgery to repair a chronic rotator cuff t ear (54 shoulders) were followed for an average of 25.9 months (range, 16 to 43). Forty-nine of 54 patients had at least 20 months of follow up. The average age of the male patients (N = 37) was 52 (range, 24 to 80) and of the female patients (N = 17) was 56 (range, 38 to 72). All of these patients received a functional evaluation based on the Shoul der and Elbow Surgery Society classification system. Forty-eight patie nts had an individual examination and 33 patients had an isokinetic st rength evaluation. There were 43 patients (80%) with a satisfactory fu nctional result and 11 (20%) with an unsatisfactory result. Unsatisfac tory results were associated with large and massive tears and decrease d postoperative range of motion. Good functional results were obtained by open repair and subacromial decompression for rotator cuff tear. A rthroscopic evaluation and treatment did not affect the functional out come, but it did increase costs by about $2000 per patient. Arthroscop y is useful to define tear size, which may affect the surgical approac h, but the arthroscopic treatment of glenohumeral problems did not alt er the functional result. The routine use of arthroscopy before rotato r cuff repair is costly, not effective, and therefore not recommended.