Substantial improvements in strength, function, and other outcomes can be seen in most patients who undergo early surgery to repair tears in the shoulder rotator cuff muscles, according to a recent study.
“Repairs of isolated supraspinatus tears maintained considerable improvement in clinical and radiographic outcomes at 10 years,” per the study, published recently in The Journal of Bone & Joint Surgery, that provides new evidence that early surgery for supraspinatus tears can improve long-term outcomes by preventing later rotator cuff muscle degeneration.
In the study, the research team identified 511 patients at 15 French hospitals who underwent surgery in 2003 to repair isolated, complete (full-thickness) supraspinatus tears. At least 10 years later, 288 patients returned for follow-up evaluation, including magnetic resonance imaging (MRI) scans in 210 patients. The patients’ average age at the time of surgery was 56.5 years, with nearly equal numbers of women and men.
According to the results, most patients experienced substantial improvement The average Constant score—a standard assessment accounting for shoulder motion, strength, daily activities, and pain—improved from about 52 (out of a possible 100) before surgery to 78 at 10 years’ follow-up. Key patient-rated outcomes also showed meaningful improvement, explains a media release from Wolters Kluwer Health.
The MRI scans showed healing in more than 80% of tendons, although most had at least a minor residual tear. The MRI evidence of tendon healing was closely related to the Constant score, especially in terms of strength.
Healing and recovery were not as good in patients who had MRI evidence of fat accumulation within the repaired supraspinatus muscle—a sign of muscle degeneration. Outcomes were similar for patients who had open versus arthroscopic (minimally invasive) surgery. The degree of preoperative retraction (pulling back) of the torn muscle was not a major factor affecting the 10-year outcomes, the release continues.
The study had some limitations, the authors note. For example, many patients were not available for follow-up. But long-term data on this still-large number of patients enables “reliable analysis of repair integrity and longevity” after isolated supraspinatus repair, per the release.
[Source(s): Wolters Kluwer Health, Science Daily]