Objectifs. - Evaluer les resultats a long terme de la suture de la coiffe des rotateurs et chercher d'eventuels facteurs predictifs pre- et/ou peroperatoires.Patients et methodes. - Tous les patients ayant subi une suture de la coiffe des rotateurs, a ciel ouvert, pour une dechirure transfixiante entre 1990 et 1996 et ayant un recul d'au moins 4 ans ont ete contactes. La technique operatoire et la reeducation postoperatoire etaient standardisees. Certains facteurs (age, sexe, cote dominant, douleurs, duree des symptomes, limitation de la mobilite active) ayant pu influencer le resultat final ont ete notes.Resultats. - Vingt-six hommes et 24 femmes sur un total de 56 patients ont ete retenus. L'age moyen etait de 58,5 ans. La duree des symptomes etait en moyenne d'un an avec des extremes de 3 a 48 mois. Avant l'operation, l'antepulsion active etait en moyenne de 144 o , l'abduction active de 135 o et la rotation externe coude au corps de 39 o . La taille de la dechirure, mesuree durant l'intervention, variait de 1 a 5 cm. Les patients ont estime avoir recupere le maximum de la force de l'epaule (75 % de la force anterieure a la dechirure) apres un delai moyen de 10 mois. Apres une evolution moyenne de 6 ans, une reduction significative des douleurs (de 2,18/3 a 0,98/3 ; p < 0,001) a ete constatee bien que 2/3 des patients signalaient encore des douleurs occasionnelles de l'epaule. Dix pour cent des patients etaient insatisfaits. Un quart des patients ont ameliore la mobilite de l'epaule. Le score de Constant postoperatoire etait de 65/100. Il persistait une difficulte a prendre un objet situe au-dessus de la tete. Aucun veritable facteur pre- ou peroperatoire predictif du resultat a long terme n'a ete trouve.Conclusion. - Dans cette serie de patients, la suture de la coiffe des rotateurs a reduit l'intensite des douleurs. Le resultat definitif n'a ete atteint qu'apres un peu moins d'un an. La mobilite articulaire n'a ete amelioree que dans une minorite des cas.
Objectives. - To evaluate the results of rotator cuff repair and to look for preoperative and/or intraoperative predictors of long-term outcomes.Patients and methods. - All patients who underwent open rotator cuff repair surgery for a full-thickness tear between 1990 and 1996 and who were subsequently followed-up for at least 4 years were contacted. The surgical technique and postoperative rehabilitation program were standardized. We recorded factors potentially associated with outcomes (age, sex, dominant hand, pain, symptom duration, and active range-of-motion limitation.Results. - Of the 56 patients identified, 26 men and 24 women with a mean age of 58.5 years were included in the study. Mean symptom duration was 12 months (range, 3-48 months). Before surgery, mean active range of motion of the shoulder was 144 o for forward elevation, 135 o for abduction, and 39 o for lateral rotation with the elbow at the side. The size of the tear measured during surgery was 1 to 5 cm. Mean time to recoveryof shoulder power (75% of the value before the tear) as assessed by the patients was 10 months. After a mean follow-up of 6 months, a significant reduction in pain was noted (from 2.18/3 to 0.98/3; p < 0.001), although two-thirds of patients reported occasional pain. Six patients were dissatisfied. Range of motion was improved in one-fourth of patients. Constant's score after surgery was 65/100. Persistent difficulty in taking objects down from high shelves was noted. None of the preoperative or intraoperative factors studied predicted the long-term outcomes.Conclusion. - In this series of patients, rotator cuff repair reduced pain severity. Nearly a year was needed to achieve the final result. Only a minority of patients experienced an improvement in range of motion.