Abstract
Over 40 months, 264 arthroscopic rotator cuff repairs were assessed prospectively. Preoperatively all patients were assessed using a modified Constant score and Visual Analogue Pain Scale (VAPS). The mean age at surgery was 59 years (19 to 83). In 151 cases (62%) the shoulders were on the dominant side. All patients underwent postoperative ultrasonography to assess cuff integrity at three weeks. Twenty-two patients were lost to follow-up. Of the rest, 210 were clinically reviewed and Constant scores produced. The remaining 32 were assessed using the VAPS and a subjective satisfaction questionnaire.
The Constant score improved by a mean of 29.6, with 166 patients (69%) reporting complete resolution of pain. The subjective outcome was rated excellent by 162 patients, good by 55, moderate by 20 and poor by five. There were 13 retears, 11 of which were identified on the three-week ultrasound. When four of these were revised, two required subscapularis repair. Importantly, five patients with retears had excellent subjective outcome. Complications were five superficial infections, 13 cases of transient neuritis following interscalene nerve blocks, four cases of bursitis, which required debridement and suture removal, and two anchor pull-outs. The overall reoperation rate was 4%.
Arthroscopic rotator cuff repair offers excellent objective and subjective outcomes, particularly pain relief. Ultrasonography at three weeks is a good indicator of whether or not a repair has taken.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
