hibbey, babos, nosek: results of open rotator cuff reconstructions results of open rotator cuff...
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Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Results of open rotator cuff reconstructions
Cs Hibbey, A Babos, Z Nosek
St. Borbála HospitalTatabánya
Hungary
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Material and method
Between 1992-2005 223 cuff reconstructions were performed
With acromioplasty in 181, without it in 42 cases
Extension of tear after Post (1-4.):– small (≤ 1 cm) 35 cases– middle (1-3 cm) 74 cases– big (3-5 cm) 33 cases– large (> 5 cm) 19 cases
Shape of acromion after Bigliani:– I. type: 6.2 %– II. type: 40.4 %– III. type: 53.4 %
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Material and method
161 patients have been succeeded to follow
5,6 years (0.5 – 13.5) follow up
Tests before procedure and at follow up:– Constant-Murley (max. 100 points)
without correction correction after Constant correction after Katolik correction after Yian
– UCLA (max. 35 points)– SST (max. 12 points)– ASES (visual analog scale + daily activity, 10+30 points)
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Complications of 223 cases
5 tendon necrosis (2,2 %) 3 superficial inflammation 1 anchor tears off 3 temporary numbness after plexus anethesia
Student t test - continous variables Khi square test - categorical variables significant difference: p<0,05 strongly significant difference: p<0,01
Statistics
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Results
Exellent (>90 %)
Good (80-89 %)
previous two groups
Fair (70-79 %)
Poor (<70 %)
CM corrected after Katolic
93 28 75,1 % 15 25
UCLA 87 32 73,9 % 9 33
SST 105 13 73,3 % 10 33
ASES 104 16 74,5 % 16 25
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Results
70
75
80
85
90
95
100
CM
CM
-C
onst
ant
CM
-Yia
n
CM
-K
atol
ik
UC
LA SS
T
AS
ES
%
55
60
65
70
75
80
85
CM
CM
-C
on
stan
t
CM
-Yia
n
CM
-K
ato
lik
UC
LA
SS
T
AS
ES
Rate of excellent and good resultsAverage follow up scores
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Satisfaction of patients: 4.6 (p<0,001)
0102030405060708090
100
1 (<1cm)
2 (1-3cm)
3 (3-5cm)
4 (>5cm)
0 discontent
1
2
3
4
5 content
Size of tears after Post
%
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Improve of pain: from 2.3 to 8.5
0
10
20
30
40
50
60
70
80
0 2 4 6 8 10
preop.
postop.
Intensity of pain (0: huge pain, 10: no pain)
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Function and range of motion
preop. postop. % of the max. value
p value
Absolut CMactivity motion
strength
2,611,40,9
17,735,113,3
89 %88 %53 %
<0,001<0,001<0,001
SST (max. 12)
1,8 10,3 86 % <0,001
ASES ADL (max. 30)
6,4 25,7 85 % <0,001
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Factors tended to cause poor result (CM<70)
low preop. score 11,5 - 17,3
low score of the intact shoulder 73,3 - 89,8
extension of tear 3,4 - 2,2
poor - average group
Average CM score
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Shape of acromion (p<0,0001)
0
10
20
30
40
50
60
I. II. III.
tear gruop
other
%
Type of acromion after Bigliani
Hibbey, Babos, Nosek: Results of open rotator cuff reconstructions
Statistical relationships p<0.01
preoperative CM value lower in women extension of tear wider in women wide of tear strictly related to
– postoperative scores– pain– satisfaction