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Clinical and structural outcome 22 years after acromioplasty without tendon repair in patients with subacromial pain and cuff tears
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Kalmar County Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
2017 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 26, no 7, p. 1262-1270Article in journal (Refereed) Published
Abstract [en]

Background: Long-term results regarding tear progression, arthropathy, and clinical scores of unrepaired rotator cuff tears are largely unknown. This study investigated whether the condition of the glenohumeral joint and rotator cuff had deteriorated at a minimum of 20 years after an acromioplasty without cuff repair and assessed the clinical results. Methods: A retrospective analysis was conducted of a consecutive series of patients treated between 1989 and 1993 with acromioplasty without cuff repair due to subacromial pain and cuff tear. At follow-up results of x-ray, ultrasonography, and clinical scores were recorded. Results: At a mean of 22 years (range, 21-25 years), 69 patients were available for follow-up with Western Ontario Rotator Cuff Index, Constant-Murley (CM) score, x-ray, and ultrasonography. Mean age at operation was 49 years (range, 19-69 years). There were 45 partial-thickness tears (PTT) and 24 full-thickness tears (FTT). Of 23 patients with FTT, 17 (74% with x-ray) had developed cuff tear arthropathy (Hamada amp;gt;= 2) and 20 (87% with ultrasonography) had progressed in tear size. Mean relative CM in patients with FTT and cuff tear arthropathy was 62 (standard deviation [SD], 27), and the mean WORC was 58% (SD, 26%). In the 43 PTT patients, 3 (7% with x-ray) had developed cuff tear arthropathy and 16 (42% with ultrasonography) had tear progression. With PTT at follow-up, the mean relative CM was 101 (SD, 22), and the mean WORC was 81% (SD, 20%). Conclusions: After an acromioplasty, most unrepaired full-thickness tears will, in long-term, increase in size and be accompanied by cuff tear arthropathy changes. Most partial thickness tears remain unchanged; cuff tear arthropathy is rare, and clinical scores generally good. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER , 2017. Vol. 26, no 7, p. 1262-1270
Keyword [en]
Shoulder; rotator cuff; long-term; tear progression; cuff tear arthropathy; acromioplasty; natural history
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-140975DOI: 10.1016/j.jse.2016.11.012ISI: 000406341000026PubMedID: 28131687OAI: oai:DiVA.org:liu-140975DiVA: diva2:1142307
Note

Funding Agencies|Medical Research Council of Southeast Sweden [FORSS 383191]

Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2017-10-18

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Ranebo, MatsBjörnsson Hallgren, HannaNorlin, RolfAdolfsson, Lars
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Orthopaedics in LinköpingOrthopaedics and Sports Medicine
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