Orthopaedics and Traumatology, Hospital de Bellvitge, Barcelona, Spain

Purpose: Transverse rotator cuff tears are usually more difficult to treat than U shaped pattern ones.The purpose of the present study is to compare the results after open repair of transverse and U-shaped cuff tears by means of two different techniques.

Material and Methods: We operated on 48 patients with complete rotator cuff tears of similar size. Ages ranged from 56 to 62 years old (mean 58,2). All underwent anterior acromioplasty, 24 had transverse torn supraspinatus and were reattached through a groove to bone with Masson Allen polyester suture, the remaining 50% had U-shaped rupture and were repaired by local transfer of the most superior part of the infraspinatus after subperiostal desinsertion, further superior movilization and the same technical suture reattachment. Constant score test for functional analysis and Cybex Norm apparatus for Isokinetic measuruments were used. Student T was the statistic method employed. Follow up averaged from 6 to 12 months.

Results: Average preoperative Constant score of transverse ruptures were 58,4 (55-62), average Constant score for U-pattern was 56,9 (54-58). Average postoperative Constant of local plasties performed in U ruptures were clearly better than direct sutures made in transverse ones 77,4 versus 89,2 (P<0.05). Only strength parameter was not improved in plasties, peak torque at 90 of external rotation was 7Ft/Lbs in the later compared with 13 in the former. Plasties group neded only 30,1rehabilitation sessions and direct serie neded 52,5.

Conclusion: When supraspinatus rupture retracts it may cause U-shaped ruptures, infraspinatus superior movilization has offered us good results probably because replaces supraspinatus function, avoiding sutures under tension of a bad quality tendon. Lost of force in external rotation does not alter the global results and return to activity is faster.