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Open Rotator Cuff Repair – Clinical Outcomes

- Outcomes:
    - in the report by Cofield RH, et al. (2001), 105 shoulders with a chronic rotator cuff tear underwent open surgical repair and acromioplasty between 1975 and 1983;
           - patients were followed for an average of 13.4 years (range, two to twenty-two years);
           - there were 16 small tears, 40 medium tears, 38 large tears, and 11 massive tears;
           - tears were repaired directly (72 tears), by V-Y plasty (12), by tendon transposition (twenty), or by reinforcement with a fascia lata graft (one);
           - long head of the biceps had been previously torn in eleven shoulders and was tenodesed in three other shoulders. In fifty-six shoulders, the distal  part of the clavicle was excised for treatment of degenerative arthritic changes, often associated with osteophyte formation;
           - satisfactory pain relief was obtained in 96 shoulders (p < 0.0001);
           - there was significant improvement in active abduction (p < 0.001) and external rotation (p < 0.007) as well as in strength in these directions of movement;
           - at the latest follow-up evaluation, the result was rated as excellent for 68 shoulders, satisfactory for 16, and unsatisfactory for 21;
           - tear size was the most important determinant of outcome with regard to active motion, strength, rating of the result, patient satisfaction, and need for a reoperation;
           - older age, less preop active motion, preoperative weakness, distal clavicular excision, and a transposition repair technique were all associated w/ larger tear size.
           - ref: Surgical Repair of Chronic Rotator Cuff Tears. A Prospective Long-Term Study.