An Analysis of Rotator Cuff Repair

Fifty-four patients who had surgery to repair a chronic rotator cuff tear (54 shoulders) were followed for an av erage of 25.9 months (range, 16 to 43). Forty-nine of 54 patients had at least 20 months of followup. The aver age 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 func tional evaluation based on the Shoulder and Elbow Sur gery Society classification system. Forty-eight patients had an individual examination and 33 patients had an isokinetic strength evaluation. There were 43 patients (80%) with a satisfactory functional result and 11 (20%) with an unsatisfactory result. Unsatisfactory results were associated with large and massive tears and de creased postoperative range of motion. Good functional results were obtained by open repair and subacromial decompression for rotator cuff tear. Arthroscopic evalu ation and treatment did not affect the functional out come, but it did increase costs by about $2000 per pa tient. Arthroscopy is useful to define tear size, which may affect the surgical approach, but the arthroscopic treatment of glenohumeral problems did not alter the functional result. The routine use of arthroscopy before rotator cuff repair is costly, not effective, and therefore not recommended.