Surgery in massive ruptures of the rotator cuff: results as related to prognosis

The results obtained in the surgical treatment of massive lesions of the rotator cuff are quite often inferior to what is expected, because prognosis is not respected. To demonstrate that the quality of the results obtained is directly proportional to the preoperative prognostic factors a retrospective study was conducted on 28 patients submitted to massive lesion repair of the rotator cuff between 1990 and 1996; the criteria of inclusion was: a) patients aged under 65 years; b) preoperative radiographic findings with acromiohumeral distance not less than 6 mm; c) degeneration of the tendons not greater than a Goutallier stage 2; d) absence of inveterate pseudoparalysis of the limb involved; e) absence of anterosuperior subdislocation of the humeral head. The results obtained with a mean follow-up of 5 years revealed a mean Constant score of 85 points (minimum 79, maximum 91) that may correspond to excellent results, showing how this type of surgery may guarantee good results only when factors of prognosis are respected preoperatively.