Functional Outcomes and Health-Related Quality of Life After Surgical Repair of Full-Thickness Rotator Cuff Tears Using a Mini-Open Technique

Abstract

Background:

Although good short-term and midterm outcomes are reported for mini-open rotator cuff repair, few prospective studies have investigated long-term results.

Hypothesis:

Function and health-related quality of life (HRQL) outcomes would be maintained 10 years after mini-open rotator cuff repair.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients with a confirmed full-thickness rotator cuff tear who underwent mini-open repair between April 1997 and July 2000 were evaluated preoperatively as well as 1 year and 10 years postoperatively for (1) pain, function, and HRQL using the American Shoulder and Elbow Surgeons (ASES) score and Western Ontario Rotator Cuff Index (WORC) score; (2) active shoulder range of motion (ROM) using goniometry; and (3) satisfaction by an independent evaluator. Changes in function, HRQL, and ROM over time were analyzed using repeated-measures analysis of variance.

Results:

A total of 84 patients were enrolled, of which 61 (73%) were men; the mean (±SD) age was 53.0 ± 9.9 years. At 10 years, 4 (5%) patients were deceased, and 4 (5%) had symptomatic retears. Fifty-nine (74%) patients were evaluated, composed of 43 (73%) men; 26 (44%) were younger than 60 years. Function and HRQL significantly improved over the course of follow-up (P < .001), primarily within the first postoperative year. At 10 years, the mean ASES score was 90.4 ± 19.4, similar to the 1-year score of 91.1 ± 12.0 (P = .83). The mean WORC score at 10 years was 88.7 ± 17.8, with no change from the 1-year score of 88.4 ± 13.6 (P = .93). This relationship did not change after adjusting for age and tear size. Shoulder ROM was also maintained over 10 years. Flexion ROM improved in the first postoperative year, and this improvement was sustained at 10 years after surgery (P ≥ .30). External rotation ROM was slower to improve postoperatively, and significant improvements were seen between 1 and 10 years (P < .01). Fifty-three patients (90%) were satisfied or very satisfied with their results. Tear size, workers’ compensation board claimant status, sex, and smoking status did not influence HRQL or shoulder ROM (P > .06).

Conclusion:

Postoperative improvements in function and HRQL after mini-open rotator cuff repair were retained at 10 years.

Keywords

mini-open rotator cuff repair health-related quality of life range of motion

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References

Baysal

Balyk

Otto

Luciak-Corea

Beaupre

. Functional outcome and health-related quality of life after surgical repair of full-thickness rotator cuff tear using a mini-open technique. Am J Sports Med. 2005;33(9):1346-1355.

Bell

Lim

Coghlan

. Long-term longitudinal follow-up of mini-open rotator cuff repair. J Bone Joint Surg Am. 2013;95(2):151-157.

Duquin

Buyea

Bisson

. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med. 2010;38(4):835-841.

Galatz

Griggs

Cameron

Iannotti

. Prospective longitudinal analysis of postoperative shoulder function: a ten-year follow-up study of full-thickness rotator cuff tears. J Bone Joint Surg Am. 2001;83(7):1052-1056.

Gartsman

Khan

Hammerman

. Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 1998;80(6):832-840.

Kirkley

Alvarez

Griffin

. The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: the Western Ontario Rotator Cuff Index. Clin J Sport Med. 2003;13(2):84-92.

Kluger

Bock

Mittlbock

Krampla

Engel

. Long-term survivorship of rotator cuff repairs using ultrasound and magnetic resonance imaging analysis. Am J Sports Med. 2011;39(10):2071-2081.

Michener

McClure

Sennett

. American Shoulder and Elbow Surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg. 2002;11(6):587-594.

Mohtadi

Hollinshead

Sasyniuk

Fletcher

Chan

. A randomized clinical trial comparing open to arthroscopic acromioplasty with mini-open rotator cuff repair for full-thickness rotator cuff tears: disease-specific quality of life outcome at an average 2-year follow-up. Am J Sports Med. 2008;36(6):1043-1051.

10.

Vastamaki

Lohman

Borgmastars

. Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair. Clin Orthop Relat Res. 2013;471(2):554-561.