Rotator cuff repair tension as a determinant of functional outcome

This study evaluated the effect of rotator cuff repair tension on surgical outcome. A total of 67 consecutive rotator cuff repairs for full-thickness tendon tears were prospectively evaluated. Rotator cuff repair tension was quantified by means of an intraoperative calibrated tensiometer after cyclic loading. The point of maximum repair tension was measured. Patients were evaluated for pain and improvement before and after surgery through use of Constant scores, American Shoulder and Elbow Surgeons' functional criteria, isokinetic strength-testing, and visual analog scale scores. Increased repair tension correlated with lesser gains in postoperative Constant score, a decrease in perceived improvement, decreased isokinetic strength measurements, and increased pain. Tension on repaired rotator cuff tendons should be minimized. High-tension repairs--those greater than 8 lb--are associated with poor subjective and objective outcomes and are not recommended.