Intermediate term functional outcome prediction following full thickness rotator cuff tear reparative or not reparative surgery

• Published in: Orthopaedics & traumatology, surgery & research Vol. 96; no. 7; pp. 727 - 733
• Main Authors: Goutallier, D, Postel, J.-M, Chevalier, X, Beaudreuil, J, Zilber, S
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-11-2010
• Subjects: Constant score; Fatty degeneration index; Follow-Up Studies; Humans; Muscle fatty degeneration; Muscle Strength; Orthopedics; Palliative Care; Predictive Value of Tests; Range of Motion, Articular; Recovery of Function - physiology; Regression Analysis; Retrospective Studies; Rotator Cuff - physiopathology; Rotator Cuff Injuries; Rotator cuff tear; Surgery; Surgical treatment; Suture Techniques; Tendon Injuries - etiology; Tendon Injuries - physiopathology; Tendon Injuries - surgery; Time Factors; Treatment Outcome; Fatty degeneration index; Rotator cuff tear; Constant score; Muscle fatty degeneration; Surgical treatment
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2010.05.003

Summary Although simple suturing repair of a full thickness cuff tear can be performed when the preoperative fatty degeneration index (FDI) is 2 or less, it is not known if the functional results will be better than palliative surgical treatment. The aim of this study is to describe and validate a method to predict the intermediate term unweighted Constant scores of different surgical treatments based on preoperative FDI. The hypothesis of this study is that the preoperative and final follow-up ratios FDI/final follow-up Constant scores regression lines, established on a previous “reference study” [5] (a series of 29 shoulders with cuff tears and sutured intact rotator cuff), could be used for this purpose. Material The present study included seven series of sutured cuffs (five, which resulted in intact cuffs and two in recurrent tears) and one series of cuffs treated with palliative surgery. Knowledge of the preoperative FDI and the location of the recurrent or unrepaired tears were required criteria for these series inclusion in the study. Method For each of the series in this study the Constant scores and selected score items were compared to scores calculated with the same mathematical formulas previously used to determine the regression lines in the reference study series (resulting in Constant scores in relation to preoperative and final follow-up FDI). Results The calculated Constant scores were similar to those reported by the authors, which validate the proposed method. Discussion Because of the small size of the series of sutured cuffs with recurrent tears and of cuffs that underwent palliative surgery and arthroscopic treatment it is impossible to definitely confirm the validity of this method. Conclusion The intermediate term results of different surgical treatments can reasonably be predicted for full thickness tendon tears based on the preoperative FDI and the location of these tears. With this method the best treatment should be chosen for a rotator cuff tear on a case-by-case basis. Level of evidence Level IV.