The effect of surgery for rotator cuff disease on general health status. Results of a prospective trial.
BACKGROUND
Previous studies of the effect of rotator cuff surgery have concentrated on limb-specific or surgeon-based outcome criteria. We conducted a prospective trial to determine the effect of surgery for rotator cuff disease on general health status.


METHODS
Seventy-one patients (fifty of whom were men and twenty-one of whom were women) with a mean age of 56.1 years were enrolled in the study. In addition to routine clinical and radiographic evaluation, all patients completed the Short Form-36 (SF-36) health-status questionnaire and five limb-specific questionnaires preoperatively and at six, twelve, eighteen, and twenty-four months postoperatively. All patients had a standard open acromioplasty and resection of the subacromial bursa. Thirty-one patients had repair of an associated rotator cuff tear. Sixty-seven patients (94 percent) completed the study; the remaining four patients were lost to follow-up.


RESULTS
The preoperative SF-36 scores for physical function (60.6, p = 0.02), role function-physical (20.8, p = 0.001), pain (38.6, p = 0.003), physical component summary (37.0, p = 0.001), and mental component summary (45.6, p = 0.02) were significantly decreased compared with normative data. The preoperative limb-specific scores also were low. At the time of the most recent follow-up evaluation, there was improvement that approached or reached significance both in the limb-specific scores (p < or = 0.0026) and in the general-health-status scores for pain (p = 0.0001), role function-physical (p = 0.06), vitality (p = 0.01), and physical component summary (p = 0.01). The presence of a rotator cuff tear had a significant negative effect on limb-specific scores both preoperatively (p = 0.04) and postoperatively (p = 0.05). Although operative treatment of rotator cuff disease led to improved scores, patients who had filed a Workers' Compensation claim had lower limb-specific and SF-36 scores both preoperatively (p = 0.02 and p = 0.01, respectively) and postoperatively (p = 0.01 and p = 0.005, respectively).


CONCLUSIONS
Surgery for chronic rotator cuff disease reliably and significantly improves general health status.
McKee
M D
MD
Department of Surgery, St. Michael's Hospital and the University of Toronto, Ontario, Canada. mckee@the-wire.com
Yoo
D J
DJ
D000174:Acromion / Q000601:surgery; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002061:Bursa, Synovial / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000534:rehabilitation / Q000601:surgery*; D009784:Occupational Diseases / Q000601:surgery; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000503:physiopathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014942:Workers' Compensation