Long-term functional outcome of repair of large and massive chronic tears of the rotator cuff

Background There have been conflicting reports regarding the effect of the size of a tear of the rotator cuff on the ultimate functional outcome after repair of the rotator cuff. While some authors have reported that the size of the tear does not adversely affect the overall result of repair, others have reported that the outcome is less predictable after repair of a large tear than after repair of a small tear. The purpose of the present study w as to examine the long-term functional outcome and the recovery of strength in thirty consecutive patients who had had repair of a large or massive te ar of the rotator cuff. Methods: Thirty consecutive patients who had operative repair of a large or massive chronic tear of the rotator cuff had a comprehensive isokinetic as sessment of the strength of the shoulder preoperatively, twelve months post operatively, and a mean of sixty-five months (range, forty-sis to ninety-th ree months) postoperatively. The functional outcome was assessed with the U niversity of California at Los Angeles shoulder score. Results: All patients reported that they were satisfied with the result and had increased strength compared with preoperatively There was a significan t decrease in pain (p < 0.01) and significant improvements in function (p < 0.01) and the range of motion (p < 0.01), The mean University of Californi a at Los Angeles shoulder score increased significantly from 12.3 points pr eoperatively to 31.0 points at the most recent follow-up examination (p < 0 .01), The mean peak torque in flexion abduction, and external rotation incr eased significantly to 80 percent (p < 0.01) 73 percent (p < 0.01), and 91 percent (p < 0.01), respectively; of that of title uninvolved shoulder by t he time of the most recent follow-up examination. Conclusions: Repair of a large or massive tear of the rotator cuff can have a satisfactory long-term outcome. The results of the Present study suggest that more than one year is needed for complete restoration of strength. Th e strength of the affected shoulders still did not equal that of the unaffe cted, contralateral shoulders by the time of the long-term follow-up.