Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis

Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; Silva, Luciana Andrade da; Sella, Guilherme do Val; Lopes Neto, Douglas Lobato; Muchiuti Junior, Melvis; Checchia, Sergio Luiz

doi:10.1016/j.rboe.2014.03.025

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Original Articles • Rev. bras. ortop. 49 (02) • Mar-Apr 2014 • https://doi.org/10.1016/j.rboe.2014.03.025 copy

Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis^☆ ☆ Please cite this article as: Miyazaki AN, Fregoneze M, Santos PD, da Silva LA, do Val Sella G, Neto DLL, et al. Avaliação funcional do reparo artroscópico da lesão do manguito rotador em pacientes com pseudoparalisia. Rev Bras Ortop. 2014;49:178-182. ,^☆☆ ☆☆ Work performed in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, Fernandinho Simonsen Wing.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to evaluate the functional result from arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis, defined as incapacity to actively raise the arm above 90^◦ , while complete passive elevation was possible.

METHODS:

we reevaluated 38 patients with a mean follow-up of 51 months (minimum of 24). We analyzed the pseudoparalysis reversion rate and the functional result obtained.

RESULTS:

according to the assessment criteria of the University of California in Los Angeles (UCLA), 31 (82%) patients had good and excellent results, two (5%) had fair results and five (13%) had poor results. The mean active elevation went from 39^◦ before the operation to 139^◦ after the operation (p < 0.05); the mean active lateral rotation went from 30^◦ to 48^◦ (p < 0.05) and the mean active medial rotation went from level L3 to T12 (p < 0.05).

CONCLUSION:

arthroscopic repair of rotator cuff injuries produced good and excellent results in 82% of the cases and a statistically significant improvement of active range of motion, with reversion of the pseudoparalysis in 97.4% of the cases. It is therefore a good treatment option.

Paralysis; Rotator cuff/injuries; Shoulder joint/surgery

No.	Sex	Age	Dominance	?T (days)	Follow-up	Pre-op active	Tendon	Size	Post-op active	UCLA
		(years)			(months)	ROM: EL, LR, MR			ROM: EL, LR, MR

1	F	75	+	21	24	50, 45, T7	SS + IS	L	130, 45, T7	16
2	F	61	-	7	24	80, 40, T7	SS + IS	L	140, 45, T12	31
3	M	68	+	2	35	30, 45, L2	SS + IS	EXT	140, 30, T12	32
4	F	71	+	4	74	0, 30, L5	SS + IS	EXT	140, 30, T10	18
5	M	72	+	30	116	80, 45, L3	SS + IS	EXT	150, 45, L1	32
6	F	78	-	7	65	0, 0, L3	SS + IS	EXT	150, 60, L1	34
7	F	81	+	30	26	60, 30, T7	SS + IS	EXT	140, 40, T7	34
8	F	73	+	20	49	0, 30, TR	SS + IS + SUB	EXT	150, 60, L3	34
9	F	76	+	3	48	0, 10, L5	SS + IS + SUB	EXT	130, 60, L1	34
10	F	75	+	20	38	80, 30, L1	SS + IS + SUB	EXT	120, 40, L1	10
11	M	72	+	4	72	30, 60, GL	SS + IS	EXT	160, 60, T8	34
12	M	60	+	14	94	45, 30, L3	SS + IS	EXT	150, 45, T10	34
13	M	67	-	14	45	30, 10, T7	SS + IS + SUB	EXT	150, 60, T8	34
14	M	64	+	7	87	0, 30, L3	SS + IS + SUB	EXT	150, 45, L1	32
15	F	67	+	30	74	60, 0, T8	SS + IS	EXT	140, 45, L1	34
16	F	81	+	3	26	45, 20, T7	SS + IS + SUB	EXT	45, 30, T7	15
17	F	79	+	10	25	80, 0, T10	SS + IS	EXT	150, 60, L1	29
18	F	79	-	4	24	30, 30, L1	SS + IS	EXT	150, 45, L1	32
19	M	62	+	45	75	90, 60, L1	SS + IS	L	150, 60, L1	34
20	M	66	+	60	73	30, 60, L5	SS + IS	L	140, 60, L1	34
21	M	74	+	1	29	30, 0, T7	SS + IS	EXT	120, 20, L1	33
22	M	49	+	740	26	80, 50, GL	SS + IS + SUB	EXT	140, 60, L3	33
23	M	74	-	14	56	0, 0, T7	SS + IS	L	150, 50, T7	34
24	M	68	+	15	51	60, 0, L1	SS + IS	L	150, 45, L5	34
25	M	56	+	15	25	70, 20, L1	SS + IS + SUB	EXT	150, 50, T7	34
26	F	79	+	30	53	80, 60, T7	SS + IS	EXT	120, 45, L2	29
27	F	69	+	4	50	30, 80, T12	SS + IS	EXT	120, 80, T12	34
28	M	65	+	32	24	60, 45, L3	SS + IS	EXT	150, 45, L1	34
29	M	71	+	30	33	20, 70, L3	SS + IS + SUB	EXT	150, 60, T8	32
30	M	70	-	20	37	0, 60, T10	SS + IS	EXT	120, 60, L1	34
31	M	81	+	15	24	0, 0, T8	SS + IS + SUB	EXT	150, 45, L1	32
32	M	55	+	10	24	0, 0, T7	SS + IS	L	150, 45, T7	32
33	M	74	+	60	25	30, 0, T10	SS + IS	EXT	150, 0, T8	32
34	M	74	+	60	26	80, 80, L5	SS + IS + SUB	EXT	150, 60, T10	34
35	M	53	-	2	24	0, 80, T10	SS + IS	L	160, 60, T10	34
36	F	72	+	150	45	70, 45, T7	SS + IS	L	120, 45, T7	27
37	F	57	-	600	26	90, 35, T10	SS + IS + SUB	EXT	120, 45, T9	19
38	F	62	+	330	48	90, 20, GL	SS + IS	L	140, 50, T9	22

	Pre-op active ROM (mean)	Post-op active ROM (mean)	? mobility
EL	39	139	100
LR	30	48	18
MR	L3	T12	3 levels

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[1] ^*Corresponding author: E-mail: guilton@ig.com.br (G. do Val Sella).