AIM: The functional long-term results of reconstructions of massive rotator cuff tears (Bateman IV) were evaluated and analyzed. METHODS: 38 patients (6 female/32 male) had a clinical and sonographical assessment and an evaluation of the Constant score after a follow-up of 81 (60 - 160) months. Operative procedures were direct transosseous refixation in 16, local tendon shifts in 17 and deltoid flaps in 5 patients. RESULTS: The average age and sex related Constant score was 77 %. The 5 patients with the deltoid flap achieved a Constant score of 60 %, all had a sonographically detected re-tear and 4 of them rated their result as only moderate. 25/33 patients with reconstruction (76 %) rated their result as good or excellent, 5 (15 %) as satisfactory, 1 (3 %) as moderate and 2 (6 %) as poor. 12 (36 %) of the 33 patients met the sonographic criteria of a re-tear. These patients had a Constant score of 71 %, whereas 21 (64 %) patients with intact reconstruction achieved a score of 85 %. CONCLUSION: The reconstruction of massive rotator cuff tears achieves good clinical long-term results if the tendons remain intact. But even with a recurrent defect, the results have been better than in patients treated with a deltoid flap. In massive rotator cuff tears a thorough selection of the operative procedure regarding atrophy and fatty infiltration of the rotator cuff muscles as well as the tendon retraction and quality is mandatory.
AIM: The functional long-term results of reconstructions of massive rotator cuff tears (Bateman IV) were evaluated and analyzed. METHODS: 38 patients (6 female/32 male) had a clinical and sonographical assessment and an evaluation of the Constant score after a follow-up of 81 (60 - 160) months. Operative procedures were direct transosseous refixation in 16, local tendon shifts in 17 and deltoid flaps in 5 patients. RESULTS: The average age and sex related Constant score was 77 %. The 5 patients with the deltoid flap achieved a Constant score of 60 %, all had a sonographically detected re-tear and 4 of them rated their result as only moderate. 25/33 patients with reconstruction (76 %) rated their result as good or excellent, 5 (15 %) as satisfactory, 1 (3 %) as moderate and 2 (6 %) as poor. 12 (36 %) of the 33 patients met the sonographic criteria of a re-tear. These patients had a Constant score of 71 %, whereas 21 (64 %) patients with intact reconstruction achieved a score of 85 %. CONCLUSION: The reconstruction of massive rotator cuff tears achieves good clinical long-term results if the tendons remain intact. But even with a recurrent defect, the results have been better than in patients treated with a deltoid flap. In massive rotator cuff tears a thorough selection of the operative procedure regarding atrophy and fatty infiltration of the rotator cuff muscles as well as the tendon retraction and quality is mandatory.
Authors: M F Pietschmann; B Frankewycz; P Schmitz; D Docheva; B Sievers; V Jansson; M Schieker; P E Müller Journal: J Mater Sci Mater Med Date: 2012-10-23 Impact factor: 3.896
Authors: Panayiotis T Hadjicostas; Panayotis N Soucacos; Markus Theissen; Friedrich W Thielemann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2008-07-01 Impact factor: 4.342