Orthopaedics and Traumatology, Universitary Hospital Joan 23, Tarragona, Spain
Radiology Department, Reina Sofia Hospital, Tudela, Spain
Purpose: Evaluate the clinical results (adjusted Constant score) and the integrity of the rotator cuff repair, by means of MRI in patients older than 70 years who underwent an arthroscopic repair technique with a minimum follow up of 2 years.
Material and Methods: Between January 2003 and December 2005, 117 shoulders in 110 patients were repaired. We established 5 inclusion criteria which were fulfil by 29 patients with 29 shoulders repaired. Of all 11 were men's and 18 women's with a mean age of 73.8 years. The preoperative adjusted Constant score were 38 points. We assessment preoperative MRI in relation with the averaged rupture size (23.3 mm in the coronal plane and 22.1 mm in the sagital plane) and fatty degeneration. ntraoperative we assess the rupture localization and size (35.7 mm). Postoperative MRI was evaluated at 1 year follow up to determine the prevalence, size and location of tendon re-rupture.
Results: The averaged follow up was 38.4 months. Adjusted postoperative Constant score was 86 points with a 49 points of increment. All patients improve on pain. The clinical outcome was excellent-good in 80 % of the patients and fair-bad in 20%. Postoperative MRI showed 40% of the patients with tendon re-rupture. The averaged size was 15.28 mm in the coronal plane and 11.9 the sagital plane. Tendon re-rupture were more prevalent in fatty degeneration grade II-IV (91.6), massive ruptures (85.7%) and the localization was in the posterior half of the supraspinatus tendon (77.8%).
Conclusion: Complete rotator cuff repair by means of sutures anchorages with arthroscopic technique have favourable outcomes in more than 80% of the patients in spite of high prevalence of tendon re-ruptures (40%). The preoperative rupture size and fatty degeneration affect the prevalence of re-rupture. Reruptures of the supraespinatus tendon are smaller and more posterior than initial ruptures. |
