Twenty years ago, I had one of the new mini-open rotator cuff repairs. Still doing good. I'm wndering how other people did with this surgery and what to expect (like how long does this type of repair last)?
When rotator cuff repairs were first done using the mini-open technique back in 1993, surgeons didn't really know how the results would turn out years down the road. Now with the data from a new Australian study, we have some 15-to 20-year outcomes to judge this technique by.
Seventy-nine (79) patients with shoulder pain, weakness, and impingement from a supraspinatus tendon tear were enrolled between 1993 and 1996. All had a tendon repair (stitching it back to the bone) and a subacromial decompression procedure by the same surgeon.
Subacromial decompression refers to shaving away some of the bone along the acromion to take pressure off the rotator cuff. The acromion is the curved piece of bone that comes from the scapula (shoulder blade) across the top of the shoulder. A mini-open (small incision) approach using an arthroscope was used to perform the surgeries.
Results were assessed using a special patient self-survey called the UCLA score. This simple but reliable tool measures patient satisfaction with the results after rotator cuff surgery based on function, active range of motion, strength, and pain. Everyone in the study completed the survey several times: first two years after surgery, then seven years later, and one final time (between 15 and 20 years).
Slightly more than two-thirds (69 per cent) felt they had good-to-excellent results. If only overall patient satisfaction was used as a measure (i.e., no one was dissatisfied), then 84 per cent thought the results were acceptable. Some patients did experience deterioration over time of the benefits they received and three had to have a reoperation. This is to be expected with an aging adult group.
The authors concluded that the mini-open rotator cuff repair technique does provide satisfactory long-term functional results for the majority of patients who have a reparable supraspinatus tendon tear.
The fact that some of their patients were older and less active might have given better results compared with younger patients having this surgery. This is one of the first (and few) studies reporting on long-term outcomes (durability) for this procedure. Having hit the 20 year mark, we expect to see more results published over the next five years.
Simon Bell FRCS, FRACS, PhD, et al. Long-Term Longitudinal Follow-up of Mini-Open Rotator Cuff Repair. In The Journal of Bone and Joint Surgery. January 16, 2013. Vol. 95A. No. 2. Pp. 151-157.
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