Return to Sports and Physical Work After Arthroscopic Superior Capsule Reconstruction Among Patients With Irreparable Rotator Cuff Tears

Am J Sports Med. 2018 Apr;46(5):1077-1083. doi: 10.1177/0363546517753387. Epub 2018 Mar 2.

Abstract

Background: Although sports participation and heavy physical work can contribute to rotator cuff tears, many patients expect to return to these activities after surgery; however, irreparable rotator cuff tears can preclude this outcome. A new surgical treatment-arthroscopic superior capsule reconstruction (SCR)-restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function and relieves pain.

Purpose: To evaluate the rates of return to sports and physical work among patients treated with arthroscopic SCR.

Study design: Cohort study; Level of evidence, 3.

Methods: From 2007 to 2014, we performed arthroscopic SCR in 105 patients with irreparable rotator cuff tears, 5 of whom were lost to follow-up. Consequently, 100 patients (mean age, 66.9 years; range, 43-82 years) were enrolled in the study. Before surgery, 26 patients had participated in sports (2 competitive, 24 recreational), and 34 patients had physical work. Rates of return to sports and physical work, the American Shoulder and Elbow Surgeons (ASES) score, active shoulder range of motion, and rate of graft tear were evaluated. The mean time to final follow-up was 48 months (range, 24-88 months).

Results: All 26 patients who played sports before their injuries returned fully to them. In addition, 32 patients returned fully to their previous physical work, whereas the 2 remaining patients returned with reduced hours and workloads. As compared with the nonsports group, the sports group had significantly higher postoperative active elevation (160° ± 32° vs 146° ± 39°; P = .04) and higher postoperative ASES scores (97 ± 7 vs 91 ± 12; P = .02). The shoulder range of motion and ASES scores before and after surgery did not differ significantly between the physical and nonphysical work groups ( P = .11-.99). The rate of graft tear did not differ between the sports group (4%) and nonsports group (5%) ( P = .75) and between the physical work group (6%) and nonphysical work group (5%) ( P = .77).

Conclusion: Arthroscopic SCR restored shoulder function and resulted in high rates of return to recreational sports and physical work.

Keywords: physical work; reconstruction; rotator cuff; sports; superior capsule; tear.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroscopy / adverse effects
  • Arthroscopy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Return to Sport*
  • Return to Work*
  • Rotator Cuff Injuries / physiopathology
  • Rotator Cuff Injuries / surgery*
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery
  • Treatment Outcome