Abstract
It is well known that the shoulder joint can restore its function without operative treatment even after a rotator cuff tear. This fact raises the question whether surgical treatment is effective on the functional recovery of a shoulder with a torn cuff. The purpose of this paper is to evaluate the effect of surgical intervention on recovery after a cuff repair and to determine whether it is influenced by the duration of symptoms.
With this aim, the authors prepared 43 patients with a r thrographically verified fullthickness tears of the cuff, who were under the age of 70 or laborers over 70 and suffering from unsatisfactory shoulder function (fair or poor in Wolfgang's criteria). Among them,21underwent surgery (at the average age of 58), while the remaining 23 refused operation and were treated conservatively (ave.62 y. o. ). The difference between the outcome of surgery and that of conservative treatment constituted the effect of surgery. Patients were followed up for 1 y. to 5 y.9 m. with an average of 2 y.3 m.
The functional results of both groups we r e compared on the basis of the duration of symptoms. In patients with symptoms lasting over 3 months, the shoulder function following surgery was found significantly better (p <0.5) than that of conservative treatment (satisfactory results: 91% vs 40%). In those with a symptomatic period shorter than 3 months, the difference was insignificant (satisfactory results: 90% vs 75%).
The authors conclude that surgery on long-standing cu f f tears is apparently effective in restoring shoulder function, but that surgery should be limited on fresh cuff tears.
