Evaluation of the Functional Outcomes of Arthroscopic Surgical Treatment of Complete Rotator Cuff Lesion with Minimum Follow-up of 10 Years

Godinho, André Couto; Santos, Flávio Márcio Lago; Donato Neto, Francisco Pereira; Silva, Paulo Victor Nunes Paz; Fonseca Júnior, Ricardo Dantas

doi:10.1055/s-0040-1715510

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Original Article, Shoulder and Elbow • Rev. bras. ortop. 55 (5) • Sep-Oct 2020 • https://doi.org/10.1055/s-0040-1715510 copy

Evaluation of the Functional Outcomes of Arthroscopic Surgical Treatment of Complete Rotator Cuff Lesion with Minimum Follow-up of 10 Years^* * Study performed by the Shoulder Surgery and Rehabilitation Group from Belo Horizonte, MG, Brazil (Ortopédico BH, Hospital Belo Horizonte and Lifecenter).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives

To analyze the functional outcomes in patients submitted to videoarthroscopic surgical treatment for compleat rotator cuff tears of the shoulder, with a minimum follow-up of 10 years.

Methods

A total of 63 patients (63 shoulders) underwent videoarthroscopic surgical repair for compleat rotator cuff tears with a minimum follow-up of 10 years. The postoperative functional outcomes of these patients were evaluated using the Constant and University of California at Los Angeles (UCLA) scores.

Results

The functional evaluation revealed mean UCLA and Constant scores of 26 and 93 points, respectively. Ninety-one percent of the subjects had satisfactory Constant scores, whereas 62% presented satisfactory UCLA scores.

Conclusion

The arthroscopic repair of rotator cuff complete tear was effective even in the long term (minimum follow-up period of 10 years). The age of the patients before surgery, size of the lesion, the degree of fatty infiltration, and evaluation of muscle trophism are important predictors of prognosis.

Keywords
shoulder; arthroscopy; rupture; rotator cuff; evaluation studies

	N	%
Gender
Female	36	57.1
Male	27	42.9
Age (years)	57.2 ± 9.6
Laterality
Right	49	77.8
Left	14	22.2

	N	%
Affected tendon(s)
SS	58	92.0
SS + IS	3	4.8
SS + SC	2	3.2
Tangent sign
Negative	57	90.5
Positive	6	9.5
Goutallier
0	24	38.1
1	25	39.7
2	14	22.2
Lesion mechanism
Degenerative	52	82.5
Traumatic	11	17.5
Lesion size
< 1 cm	8	12.7
1-3 cm	38	60.3
3-5cm	15	23.8
> 5 cm	2	3.2
Re-rupture
No	57	90.5
Yes	6	9.5
Constant score	92.8 ± 15.9 (62 to 136)
UCLA score	26.5 ± 4.3 (14 to 30)

	N	%
Anchors
1	13	20.6
2	43	68.3
3	6	9.5
4	1	1.6
LHBT
Intact	31	49.2
Tenotomy	30	47.6
Tenodesis	2	3.2
Acromioplasty
No	5	7.9
Yes	58	6.3
Mumford
No	59	93.7
Yes	4	6.3

Variable	Category	Satisfactory Constant (n = 57)	Unsatisfactory Constant (n = 6)	p-value	ES	Satisfactory UCLA (n = 39)	Unsatisfactory UCLA (n = 24)	p-value	ES
Gender	Female (n = 36)	88.9%	11.1%	0.69	0.06	58.3%	41.7%	0.05	0.008
	Male (n = 27)	92.6%	7.4%			66.7%	33.3%
Acromioplasty	No (n = 5)	80.0%	20.0%	0.40	0.10	80.0%	20.0%	0.64	0.11
	Yes (n = 58)	91.4%	8.6%			60.3%	39.7%
Mumford	No (n = 59)	91.5%	8.5%	0.34	0.14	62.7%	37.3%	0.63	0.06
	Yes (n = 4)	75.0%	25.0%			50.0%	50.0%
Lesion size	Up to 3 cm (n = 46)	88.2%	11.8%	0.66	0.05	67.4%	32.6%	0.14	0.19
	> 3 cm (n = 17)					47.1%	52.9%
Goutallier	< 2 (n = 49)	95.9%	4.1%	0.02^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	0.35	71.4%	28.6%	0.004^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	0.37
	≥2 (n = 14)	71.4%	28.6%			28.6%	71.4%
Affected	SS (n = 58)	93.1%	6.9%	0.07	0.30	63.8%	36.2%	0.36	0.13
tendons	SS + IS/SC (n = 5)	60.0%	40.0%			40.0%	60.0%
Tangent sign	Negative (n = 57)	93.0%	7.0%	0.04^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	0.26	66.7%	33.3%	0.03^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	0.30
	Positive (n = 6)	66.7%	33.3%			16.7%	83.3%
Tenotomy	No (n = 33)	97.0%	3.0%	0.09	0.23	78.8%	21.2%	0.004^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	0.36
	Yes (n = 30)	83.3%	16.7%			43.3%	56.7%
Age (years)		55.9 ± 8.9	69.3 ± 8.8	0.001^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	1.50	53.7 ± 8.6	63.0 ± 8.4	< 0.001^* * significant difference, p < 0.05; ES: effect size. - Cohen’s d [quantitative variables] small: 0.2-0.4; moderate: 0.5-0.7; high: ≥ 0.8; - Cramer’s V [qualitative variables] small: 0.1-0.2; moderate: 0.3-0.4; high: ≥ 0.5).	1.09
Number of anchors		1.9 ± 0.6	2.2 ± 1.0	0.30	0.37	1.8 ± 0.6	2.0 ± 0.6	0.21	0.33

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence André Couto Godinho, MSc, Rua dos Aimorés, 2085, Apartamento 1502, Belo Horizonte, MG, 30140-072, Brazil (e-mail: andre_cgod@hotmail.com).

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Evaluation of the Functional Outcomes of Arthroscopic Surgical Treatment of Complete Rotator Cuff Lesion with Minimum Follow-up of 10 Years* * Study performed by the Shoulder Surgery and Rehabilitation Group from Belo Horizonte, MG, Brazil (Ortopédico BH, Hospital Belo Horizonte and Lifecenter).

Abstract

Objectives

Methods

Results

Conclusion

Evaluation of the Functional Outcomes of Arthroscopic Surgical Treatment of Complete Rotator Cuff Lesion with Minimum Follow-up of 10 Years^* * Study performed by the Shoulder Surgery and Rehabilitation Group from Belo Horizonte, MG, Brazil (Ortopédico BH, Hospital Belo Horizonte and Lifecenter).