Similar results comparing early and late surgery in open repair of traumatic rotator cuff tears.

Abstract

The purpose was to investigate whether surgical repair earlier or later than 3months after injury may result in similar outcomes and patient satisfaction. Seventy-three patients (75 shoulders, 58 males, mean age 59) who had undergone surgical intervention for traumatic rotator cuff tears from 1999 to 2011 were assessed by MRI, clinical examination and Western Ontario Rotator Cuff Index (WORC) as a primary outcome measure and Oxford Shoulder score (OSS), Constant-Murley score (CS) and EQ-5D as secondary. The patients treated less than 3months after injury (n=39) were compared with patients treated more than 3months after injury (n=36). The average follow-up time was 56months (range 14-149), and the average time from injury to repair for all patients was 16weeks (range 3-104). A single senior radiologist performed a blinded evaluation of all the MRIs. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy were evaluated. No differences were found for any of the assessed outcomes (WORC, OSS, CS and EQ-5D) between the two groups. The mean WORC% was 77% for both groups. Re-tear frequency was 24%, nine in both groups. Patients with re-tear reported less satisfaction with their outcome. The surgical treatment of symptomatic traumatic rotator cuff tears repairable later than 3months after injury yields a good functional outcome, a high level of subjective patient satisfaction, and at the same level for patients receiving earlier treatment. Based on our findings, surgical repair could be encouraged whenever technically possible. Retrospective Comparative Study, Level III.