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Intermediate term functional outcome prediction following full thickness rotator cuff tear reparative or not reparative surgery - 25/10/10

Doi : 10.1016/j.otsr.2010.05.003 
D. Goutallier a, ⁎ , J.-M. Postel a, X. Chevalier b, J. Beaudreuil c, S. Zilber a
a Department of Orthopaedic Surgery and Traumatology, Henri Mondor Hospital, Paris Public Assistance Hospitals Group, Créteil School of Medicine (Paris XII University), 94010 Créteil cedex, France 
b Department of Rheumatology, Henri Mondor Hospital, Paris Public Assistance Hospitals Group, Créteil School of Medicine (Paris XII University), 94010 Créteil cedex, France 
c Department of Rheumatology, Lariboisière Hospital, Paris Public Assistance Hospitals Group, Saint-Louis-Lariboisière School of Medicine (Paris X University), 75475 Paris cedex 10, France 

Corresponding author. 7, rue Gustave-Léveillé, 94320 Thiais, France.

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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.

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Keywords : Rotator cuff tear, Surgical treatment, Constant score, Muscle fatty degeneration, Fatty degeneration index


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Vol 96 - N° 7

P. 727-733 - novembre 2010 Regresar al número
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