Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Abstract

Background Short-to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term. Questions/purposes We asked whether, after rotator cuff repair or reconstruction, pain relief, ROM, shoulder strength, and function remained over the long term. Patients and MethodsWe retrospectively reviewed 75 patients who underwent rotator cuff repair between 1980 and 1989. There were 55 men and 20 women. Their mean age at surgery was 52 years. The minimum followup was 16 years (mean, 20 years; range 16-25 years). Results Twenty-eight of the 75 patients (37%) had persistent relief of pain lasting for 20 years. In the remaining 47 patients, alleviation of pain lasted, on average, 14 years (range, 0-24 years). Mean flexion and abduction strength increased postoperatively but during long-term followup decreased to less than preoperative levels. External rotation also decreased. At the last followup, the Constant-Murley score averaged 66 (range, 10-98) in men and 60 (range, 29-89) in women. In the Simple Shoulder Test questionnaire, the mean number of yes answers was eight of 12. Of the 75 patients, 32 (43%) reported impairment in activities of daily living owing to an index shoulder complaint. Severe degenerative changes of the glenohumeral joint were evident in 14 patients (19%). Conclusions The early high functional scores after primary rotator cuff repair or reconstruction of the types we performed in the 1980s did not persist. The function achieved postoperatively was lost, as ROM and strength decreased to less than preoperative values. However, alleviation of pain was long-standing in most patients. Based on our data, we should warn patients to expect less than permanent relief with those repairs. We cannot say whether the same will apply to currently performed types of repairs.

Rotator Cuff Integrity Correlates With Clinical and Functional Results at a Minimum 16 Years After Open Repair

“…In tears larger than 3 cm, cuff integrity was greater after open than arthroscopic repair [3]. We reported our very long-term clinical and functional results after open RCR [4] and now are ready to correlate those results with cuff integrity estimated by MR arthrography.…”

“…Because we found no long-term surveys including MRI evaluation ranging more than 10 years after RCR, our aim was to study long-term cuff integrity after open RCR. In a previous review of patients undergoing open RCR, we found pain and function deteriorated with long-term followup [4]. We therefore performed this analysis to determine whether MRI results provided a reason for this deterioration.…”

Clinical and anatomic results of surgical repair of chronic rotator cuff tears at ten-year minimum follow-up

“…In our study, we found that surgical repair of chronic rotator cuff tendon tear can produce consistent and lasting pain relief and improvement in range of motion. However, a 42% re-tear rate was There are only a few series in literature reviewing the results of rotator cuff repair at ten year or more follow-up [6][7][8][9][10][16][17][18][19][20][21]. Most of the series reported only functional results but rarely anatomic evaluation of the repair.…”

Validation of the Simple Shoulder Test in a Portuguese-Brazilian Population. Is the Latent Variable Structure and Validation of the Simple Shoulder Test Stable across Cultures?

“…The questionnaire was developed based on common patient complaints presented to practitioners. Numerous studies have used this test for the assessment of shoulder function [11], [12], implying its importance and strengthening the need for cultural translation and validation to other languages, facilitating assessment of shoulder conditions among different populations groups. Test-retest reliability, construct validity and responsiveness of the SST (Simple Shoulder Test) have been thoroughly studied [11], [7], [13], [14], [15].…”