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A PROSPECTIVE EVALUATION OF FUNCTION AND STRENGTH AFTER ROTATOR CUFF SURGERY



Abstract

This study prospectively evaluated the functional outcome and strength of patients after rotator cuff surgery. Thirty-three patients were evaluated pre-operatively and post-operatively for one year. Each patient underwent clinical evaluation of shoulder range of motion and machine strength testing. Additionally they completed the SF-36, DASH, Western Ontario Rotator Cuff, and Washington Simple Shoulder Test questionnaires. The study showed that patients with small and large tears showed improvement after surgery. Smaller tears had better outcomes. Workplace Safety and Insurance Board (WSIB) patients had lower functional outcomes despite strength and range of motion showing no difference with non- WSIB patients.

This study prospectively evaluated strength and functional outcome after rotator cuff surgery.

Thirty-three patients, mean age 55.6, were evaluated pre-operatively and post-operatively for one year. Twenty-eight patients were male and five were female. Seventeen patients involved the Workplace Safety and Insurance Board and sixteen patients had non-WSIB related tears. The patients were also divided based on tear size into two groups (< 3cm and > 3.1cm). Allpatients underwent an acromioplasty. Twenty-two also had an open or mini-open repair. Two underwent arthroscopic repair. Five patients had a debridement and four patients had Latissimus Dorsi Transfer. All had an evaluation of range of motion(ROM), machine isometric strength testing, and completion of the SF-36, DASH, Western Ontario Rotator Cuff (WORC) and Washington Simple Shoulder Test (WST) at each visit.

Based on tear size, there was a significant difference in functional outcome on the SF-36 (p< 0.05), DASH (p< 0. 005), WORC (p< 0.001) and WST (p< 0.01). Within each group there was significant improvement in strength (p< 0.01) over time. The smaller tear group showed significantly greater strength. The ROM was improved within each group over time (p< 0.01), though no statistical difference was determined between groups. In comparing the sample based on WSIB status, functional outcomes were better in Non-WSIB patients (p< 0.01). Although no statistical difference in strength and ROM was noted.

Patients with both small and large tears showed improved functional outcome, strength and ROM over time, with the smaller tear group having better outcomes. WSIB patients had lower functional outcomes despite strength and ROM showing no difference between the two groups.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada