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Shoulder strength with rotator cuff tears. Pre- and postoperative analysis
D Kirschenbaum1, M P Coyle, J P Leddy
1Department of Orthopaedic Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick.
Clinical Orthopaedics and Related Research
|March 1, 1993
Summary
Rotator cuff tears cause significant shoulder weakness. Pain relief from lidocaine injections allows accurate strength measurement, showing substantial strength gains after surgery.
Area of Science:
- Orthopedics
- Sports Medicine
- Rehabilitation Science
Background:
- Rotator cuff tears often lead to significant shoulder weakness.
- Shoulder pain can mask the true extent of weakness, complicating objective assessments.
- Accurate preoperative strength measurement is crucial for evaluating surgical outcomes.
Purpose of the Study:
- To assess the impact of subacromial lidocaine injection on objective shoulder strength measurement in patients with rotator cuff tears.
- To quantify the improvement in shoulder strength following rotator cuff repair surgery at six and twelve months postoperatively.
Main Methods:
- Bilateral isokinetic shoulder strength testing was performed on 25 patients with rotator cuff tears.
- Testing included abduction, external rotation, and forward flexion strength ratios (operative vs. nonoperative shoulder).
- Evaluations were conducted pre-injection, and at six and twelve months after rotator cuff repair surgery.
Main Results:
- Preoperative strength averaged 37% for abduction, 36% for external rotation, and 33% for forward flexion.
- Six-month postoperative strength increased to 68% (abduction), 76% (external rotation), and 66% (forward flexion).
- Twelve-month postoperative strength reached 104% (abduction), 142% (external rotation), and 97% (forward flexion).
Conclusions:
- Shoulder pain significantly obscures objective weakness assessment in rotator cuff tears.
- Subacromial lidocaine injection enables accurate preoperative strength measurement.
- Rotator cuff repair surgery leads to significant and sustained improvements in shoulder strength.