Pain relief, motion, and function after rotator cuff repair or reconstruction may not persist after 16 years.
BACKGROUND
Short- to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term.


OBJECTIVE
We asked whether, after rotator cuff repair or reconstruction, pain relief, ROM, shoulder strength, and function remained over the long term.


METHODS
We retrospectively reviewed 75 patients who underwent rotator cuff repair between 1980 and 1989. There were 55 men and 20 women. Their mean age at surgery was 52 years. The minimum followup was 16 years (mean, 20 years; range 16-25 years).


RESULTS
Twenty-eight of the 75 patients (37%) had persistent relief of pain lasting for 20 years. In the remaining 47 patients, alleviation of pain lasted, on average, 14 years (range, 0-24 years). Mean flexion and abduction strength increased postoperatively but during long-term followup decreased to less than preoperative levels. External rotation also decreased. At the last followup, the Constant-Murley score averaged 66 (range, 10-98) in men and 60 (range, 29-89) in women. In the Simple Shoulder Test questionnaire, the mean number of yes answers was eight of 12. Of the 75 patients, 32 (43%) reported impairment in activities of daily living owing to an index shoulder complaint. Severe degenerative changes of the glenohumeral joint were evident in 14 patients (19%).


CONCLUSIONS
The early high functional scores after primary rotator cuff repair or reconstruction of the types we performed in the 1980s did not persist. The function achieved postoperatively was lost, as ROM and strength decreased to less than preoperative values. However, alleviation of pain was long-standing in most patients. Based on our data, we should warn patients to expect less than permanent relief with those repairs. We cannot say whether the same will apply to currently performed types of repairs.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Borgmästars
Niclas
N
Department of Orthopedics, ORTON Orthopaedic Hospital, Tenholantie 10, 00280, Helsinki, Finland.
Paavola
Mika
M
Remes
Ville
V
Lohman
Martina
M
Vastamäki
Martti
M
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D019637:Orthopedic Procedures / Q000009:adverse effects; D010027:Osteotomy; D010147:Pain Measurement; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013709:Tendon Transfer; D053656:Tenodesis; D013997:Time Factors; D016896:Treatment Outcome