title: Negative prognostic factors in managing massive rotator cuff tears.
abstract: OBJECTIVE
  To investigate the negative prognostic factors in the management of massive rotator cuff tears.
  
  
  METHODS
  Retrospective nonrandomized study.
  
  
  METHODS
  Faculty Practice associated with a major orthopedic teaching hospital.
  
  
  METHODS
  108 patients who were treated for massive rotator cuff tears were evaluated for an average of 3.2 years posttreatment. There were 58 females and 50 males, with a mean age of 61.3 years.
  
  
  METHODS
  40 patients underwent conservative nonsurgical management (Group 1), 32 patients underwent arthroscopic debridement (Group 2), and 36 patients underwent primary repair of the rotator cuff (Group 3).
  
  
  METHODS
  A detailed Shoulder Rating Questionnaire was filled out by patients pretreatment and minimal 2 years posttreatment.
  
  
  RESULTS
  Overall, Group 1 had 65% excellent or good outcomes, Group 2 had 81%, and Group 3 had 86%. The subgroup of patients in Group 1 who had cortisone injections had a 75% success rate.
  
  
  CONCLUSIONS
  Negative prognostic factors evaluated are presence of glenohumeral arthritis, decreased passive range of motion, superior migration of the humeral head, presence of atrophy, and external rotation/abduction strength less than 3. The presence of 3 or more of these negative prognostic factors are correlated with poor outcomes in the treatment of massive rotator cuff tears.
authors.affiliation: The Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021, U.S.A.
authors.forename: Vijay B
authors.initials: VB
authors.lastname: Vad
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: O'Brien
authors.forename: Howard A
authors.initials: HA
authors.lastname: Rose
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Wickiewicz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001182:Arthroscopy; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries; D013256:Steroids / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000628:therapy
chemical_list: D013256:Steroids