This prospective single-surgeon study followed 40 patients undergoing repair of chronic full-thickness rotator cuff tears. It evaluated which preoperative and intraoperative factors predict 2-year functional outcome using the normalized Constant score. Strength, satisfaction, and disability were correlated against tear size, tendon quality, activity level, and worker's compensation status.
When counseling a patient before cuff repair, tear size is your single best prognostic tool. Expect reliable pain relief regardless of size, but tell high-demand patients with large or massive tears that strength recovery is limited. In this series strength scores dropped from 22 to 10 as tears enlarged, while pain scores stayed near-normal.
A practical mental threshold: satisfactory shoulders averaged 9 cm² and unsatisfactory ones 18 cm². Larger tears also carry poor tendon quality, difficult mobilization, and biceps rupture, so a big tear on MRI predicts a harder operation and a weaker shoulder.
Do not assume a worker's compensation claim dooms the outcome. Their Constant scores matched everyone else's; they simply took longer to return to work, largely because they had higher-demand jobs. Finally, an identical Constant score means different things to different patients, which is why premorbid activity level must factor into disability assessment.
This prospective single-surgeon study followed 40 patients undergoing repair of chronic full-thickness rotator cuff tears. It evaluated which preoperative and intraoperative factors predict 2-year functional outcome using the normalized Constant score. Strength, satisfaction, and disability were correlated against tear size, tendon quality, activity level, and worker's compensation status.
When counseling a patient before cuff repair, tear size is your single best prognostic tool. Expect reliable pain relief regardless of size, but tell high-demand patients with large or massive tears that strength recovery is limited. In this series strength scores dropped from 22 to 10 as tears enlarged, while pain scores stayed near-normal.
A practical mental threshold: satisfactory shoulders averaged 9 cm² and unsatisfactory ones 18 cm². Larger tears also carry poor tendon quality, difficult mobilization, and biceps rupture, so a big tear on MRI predicts a harder operation and a weaker shoulder.
Do not assume a worker's compensation claim dooms the outcome. Their Constant scores matched everyone else's; they simply took longer to return to work, largely because they had higher-demand jobs. Finally, an identical Constant score means different things to different patients, which is why premorbid activity level must factor into disability assessment.