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Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size.
Am J Sports Med. 2016 Apr; 44(4):972-80.AJ

Abstract

BACKGROUND

The recovery of muscle strength after arthroscopic rotator cuff repair based on the preoperative tear size has not yet been well described.

PURPOSE/HYPOTHESIS

The purpose of this study was to evaluate the recovery period of muscle strength by a serial assessment of isometric strength after arthroscopic rotator cuff repair based on the preoperative tear size. The hypothesis was that muscle strength in patients with small and medium tears would recover faster than that in those with large-to-massive tears.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

A total of 164 patients who underwent arthroscopic rotator cuff repair were included. Isometric strength in forward flexion (FF), internal rotation (IR), and external rotation (ER) was evaluated preoperatively and at 6, 12, 18, and 24 months after surgery. Preoperative magnetic resonance imaging scans were assessed to evaluate the quality of the rotator cuff muscle, including fatty infiltration, occupation ratio, and tangent sign. Patient satisfaction as well as visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES), and Constant scores were assessed at every follow-up.

RESULTS

Muscle strength demonstrated the slowest recovery in pain relief and the restoration of shoulder function. To reach the strength of the uninjured contralateral shoulder in all 3 planes of motion, recovery took 6 months in patients with small tears and 18 months in patients with medium tears. Patients with large-to-massive tears showed continuous improvement in strength up to 18 months; however, they did not reach the strength of the contralateral shoulder at final follow-up. At final follow-up, mean strength in FF, IR, and ER was 113.0%, 118.0%, and 112.6% of the contralateral shoulder in patients with small tears, respectively; 105.0%, 112.1%, and 102.6% in patients with medium tears, respectively; and 87.6%, 89.5%, and 85.2% in patients with large-to-massive tears, respectively. Muscle strength in any direction did not significantly correlate with postoperative patient satisfaction (P = .374, .515, and .692 for FF, IR, and ER, respectively), whereas it highly correlated with preoperative quality of the muscle.

CONCLUSION

The recovery of muscle strength after arthroscopic repair was poorly correlated with patient satisfaction. This study recommends that regardless of pain relief and improved shoulder function, patients with larger than medium tears should be encouraged to continue with rehabilitation for the maximal restoration of muscle strength beyond 1 year postoperatively.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Korea sjshin622@ewha.ac.kr.Department of Orthopaedic Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Korea.Department of Orthopaedic Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Korea.Department of Orthopaedic Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26851272

Citation

Shin, Sang-Jin, et al. "Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size." The American Journal of Sports Medicine, vol. 44, no. 4, 2016, pp. 972-80.
Shin SJ, Chung J, Lee J, et al. Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size. Am J Sports Med. 2016;44(4):972-80.
Shin, S. J., Chung, J., Lee, J., & Ko, Y. W. (2016). Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size. The American Journal of Sports Medicine, 44(4), 972-80. https://doi.org/10.1177/0363546515625043
Shin SJ, et al. Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size. Am J Sports Med. 2016;44(4):972-80. PubMed PMID: 26851272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recovery of Muscle Strength After Intact Arthroscopic Rotator Cuff Repair According to Preoperative Rotator Cuff Tear Size. AU - Shin,Sang-Jin, AU - Chung,Jaeyoon, AU - Lee,Juyeob, AU - Ko,Young-Won, Y1 - 2016/02/05/ PY - 2016/2/7/entrez PY - 2016/2/7/pubmed PY - 2016/11/4/medline KW - muscle strength KW - recovery KW - rehabilitation KW - rotator cuff SP - 972 EP - 80 JF - The American journal of sports medicine JO - Am J Sports Med VL - 44 IS - 4 N2 - BACKGROUND: The recovery of muscle strength after arthroscopic rotator cuff repair based on the preoperative tear size has not yet been well described. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the recovery period of muscle strength by a serial assessment of isometric strength after arthroscopic rotator cuff repair based on the preoperative tear size. The hypothesis was that muscle strength in patients with small and medium tears would recover faster than that in those with large-to-massive tears. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 164 patients who underwent arthroscopic rotator cuff repair were included. Isometric strength in forward flexion (FF), internal rotation (IR), and external rotation (ER) was evaluated preoperatively and at 6, 12, 18, and 24 months after surgery. Preoperative magnetic resonance imaging scans were assessed to evaluate the quality of the rotator cuff muscle, including fatty infiltration, occupation ratio, and tangent sign. Patient satisfaction as well as visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES), and Constant scores were assessed at every follow-up. RESULTS: Muscle strength demonstrated the slowest recovery in pain relief and the restoration of shoulder function. To reach the strength of the uninjured contralateral shoulder in all 3 planes of motion, recovery took 6 months in patients with small tears and 18 months in patients with medium tears. Patients with large-to-massive tears showed continuous improvement in strength up to 18 months; however, they did not reach the strength of the contralateral shoulder at final follow-up. At final follow-up, mean strength in FF, IR, and ER was 113.0%, 118.0%, and 112.6% of the contralateral shoulder in patients with small tears, respectively; 105.0%, 112.1%, and 102.6% in patients with medium tears, respectively; and 87.6%, 89.5%, and 85.2% in patients with large-to-massive tears, respectively. Muscle strength in any direction did not significantly correlate with postoperative patient satisfaction (P = .374, .515, and .692 for FF, IR, and ER, respectively), whereas it highly correlated with preoperative quality of the muscle. CONCLUSION: The recovery of muscle strength after arthroscopic repair was poorly correlated with patient satisfaction. This study recommends that regardless of pain relief and improved shoulder function, patients with larger than medium tears should be encouraged to continue with rehabilitation for the maximal restoration of muscle strength beyond 1 year postoperatively. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/26851272/Recovery_of_Muscle_Strength_After_Intact_Arthroscopic_Rotator_Cuff_Repair_According_to_Preoperative_Rotator_Cuff_Tear_Size_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546515625043?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -