Klinische und radiologische 7-Jahres-Ergebnisse nach offener Rekonstruktion der Rotatorenmanschette

Purpose: The reconstruction of a torn rotator cuff is a common orthopedic operation. Until 1999, these reconstructions were performed in our department using a standardized, open technique. The aim of our study was to investigate the subjective and objective results 7-9 years after open rotator cuff repair. These findings could be used as a future reference in the evaluation of innovative arthroscopic rotator cuff repair techniques. Patients and Methods: Between 1996 and 1999, open repairs of full-thickness rotator cuff tears were performed in 69 patients (18 women, 51 men, mean age of 64±11 years). The refixation was performed using transosseous sutures. 55 patients (15 woman and 40 men, mean age of 66±6 years) were available for follow-up examination with an average follow-up of 7.3±0.12 years. The evaluation consisted of an assessment of the operated shoulder joint with the Constant Murley Score (CMS) in comparison to the contralateral side, retrospectively pre- and postoperative assessment using the Upper Limb Disabilities of the Arm, Shoulder and Hand (DASH) Score, a visual analogue scale (VAS) and true ap X-rays. Furthermore the quality of life was assessed using the short form 36 (SF-36). Results: The DASH score improved significantly from preoperative 61±18 points to postoperative 16±19 points (p<0.01). The patients had a significant reduction in pain intensity (VAS) from preoperative 7.3 ±1.8 to postoperative 1.5 ±2.1 points (p<0.01). The CMS showed a significant difference between the operated shoulder (80±16 points) and the nonoperated side (90±12 points) (p<0.01). A comparison of follow-up X-rays with those obtained preoperatively revealed a significant superior migration of the humeral head; however, this had no significant influence on the clinical result in the CMS. The SF-36 showed a mean value of 73.97 ±18.04 points. Conclusions: The open repair of rotator cuff tears decreases pain and improves the subjective symptoms of the affected shoulder joint.