LONG-TERM RESULTS OF OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS

The operative management of rotator cuff tears is gaining in importance: the growing proportion of elderly people with the consequent increase in frequency, more reliable diagnostic techniques (for clinical examinations and modern imaging techniques), more accurate indications for surgery and improved and more versatile operating techniques account for this development. Except for the rate occurrence of traumatic ruptures in young patients, which call for early surgical repair, operative treatment is indicated only in cases of failed conservative treatment, intractable pain and/or pseudoparalysis. The latter conditions are often encountered in manual workers, in whom the dominant side is affected. Very often, diminished physical demands after retirement reduce these discomforts to a tolerable level. This phenomenon also explains the surprisingly good long-term results in cases where surgical repair of the rotator cuff was performed more than 20 years ago. The reported percentages of these shoulders that are free or almost free of pain range between 80% and 90%, i.e., slightly higher than the percentage in younger, physically still active age groups a few years after surgery. Similarly, weakness is not perceived as such or at least not felt to be burden-some. Future evaluations of the outcome of rotator cuff repairs will be carried out according to the guidelines of the European Society for Shoulder and Elbow Surgery and the scoring system worked out by C.R. Constant; this puts more emphasis on the function, which itself is related to age- and sex-related standards.