For A.M. Release
Friday, July 7, 2000
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Joanne Swanson
(847) 384-4035, [email protected]
Shoulder surgery improves patients' overall health
ROSEMONT, Ill.-- A new study shows that rotator cuff surgery not only restores shoulder function and decreases pain, it improves the patient's general health overall.
Researchers at the University of Toronto followed 67 rotator cuff surgery patients at six-month intervals for two years. The findings are published in the July issue of The Journal of Bone and Joint Surgery, the official scientific publication of the American Academy of Orthopaedic Surgeons.
"We found that surgery for rotator cuff disease has a definite and measurable effect on the outcome of the shoulder as well as on the quality of the patient's life," said study co-author Michael McKee, MD, assistant professor, division of orthopaedics, department of surgery, St. Michael's Hospital and University of Toronto, Ontario, Canada.
The rotator cuff includes four shoulder muscles that work together enabling a person to lift overhead, throw a ball, open a door and reach an upper shelf.
Participating in the study were 71 patients who had rotator cuff impingement and/or a rotator cuff tear. Forty had inflammation, edema or thinning of the rotator cuff; 31 had a tear.
Before surgery, all patients completed questionnaires regarding shoulder pain, tenderness, mobility and quality of life. "Patients had significant impairment of upper extremity function," said Dr. McKee. "They had pain just moving the shoulder, but especially with overhead work or activity. It even hurt to sleep on the shoulder."
For at least six months (mean 10.6 months), these acute symptoms had not responded to conservative care, such as physiotherapy, medication, cortisone injection and work modifications.
Patients ranged in age from 32 years to 78 years (mean age: 56.1 years). Seventy-one patients (50 male, 21 females) underwent surgery, but four did not complete follow-up. Rehabilitation began with physiotherapy the day after surgery and, by eight weeks, progressed to unrestricted exercises.
Dr. McKee and colleagues measured the patients' perceptions of the impact of treatment on function and quality of life and then compared preoperative scores with the two-year postoperative scores. "We found no relationship between outcome and a person's age, gender or occupation," said Dr. McKee, "but two variables did impact outcomes.
"The 23 patients who had filed a Worker's Compensation claim had poorer scores both preoperatively and postoperatively compared with non-Worker's Comp patients," he said. "Although Worker's Comp patients' physical scores did improve after surgery, their overall mental health scores did not.
"The other variable, presence of a rotator cuff tear, did affect the scores both before and after surgery but did not have a significant effect on the general health status," said Dr. McKee.
From the division of orthopaedics, department of surgery, upper extremity reconstructive service, St. Michael's Hospital and University of Toronto, co-author of the study with Dr. McKee is Daniel J. Yoo.
An orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and treatment of injuries and diseases of the musculoskeletal system-the bones, joints and muscles of the body.
The 24,500-member American Academy of Orthopaedic Surgeons is a not-for-profit organization which provides educational programs for orthopaedic surgeons, allied health professionals and the public. The Academy is celebrating the years 2000-2010 as the Bone and Joint Decade. The peer-reviewed JBJS, located in Needham, Mass., is published monthly. Abstracts are available online at http://www.jbjs.org.
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