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A symptom-based classification for shoulders with massive rotator cuff defects

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Abstract

The aim of this prospective study was to propose a classification for shoulders with massive rotator cuff defects based on patients’ clinical symptoms. A total of 100 shoulders with massive rotator cuff tears were evaluated clinically using the Constant score (CS) and with radiographs in two planes. Three types were defined and correlated with radiographic findings: (1) the arthritic type (type I), (2) the non-reactive type (type II) and (3) the necrotic type (type III). Significant differences in the overall CS (type I: 28.6 points, range: 4 – 61; type II: 18.8 points, range: 6 – 52; type III: 15.5 points, range: 6 – 31) and its subgroups and in shoulder motion were found between types I and II and between types I and III (p < 0.05). This classification may be helpful for the decision-making process with regard to the appropriate form of shoulder replacement surgery in patients with massive rotator cuff defects.

Résumé

Le but de cette étude prospective est de proposer, pour les épaules présentant une rupture massive de la coiffe des rotateurs, une classification basée sur les signes cliniques. 100 épaules présentant une rupture massive de la coiffe des rotateurs ont été évaluées de façon clinique en utilisant le score de Constant (CS) et une radiographie dans les deux plans. 3 types d’épaule ont été définis et corrélés avec les découvertes radiographiques: le type 1 arthrosique, le type 2 non réactif, le type 3 nécrotique. Avec des différences significatives du score de Constant, dans le type 1, 28,6 points (4 à 61), dans le type 2,18,8 points (6 à 52) et dans le type 3,15, 5 points (6 à 31). Par ailleurs, des sous-groupes ont pu être également définis en fonction de la mobilité de l’épaule entre le type 1 et le type 2 et entre le type 1 et le type 3 (p < 0,05). Cette classification permet d’améliorer le processus de décision et de réaliser un traitement adapté en ce qui concerne notamment le remplacement de l’épaule chez ces patients présentant une rupture massive de la coiffe des rotateurs.

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Acknowledgements

This study was supported by the “Deutsche Arthrose-Hilfe e.V”.

We would like to thank Mr. Thomas Bruckner from the Institute of Biometrics (University of Heidelberg) for statistical analysis.

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Authors and Affiliations

  1. Division of Shoulder and Elbow Surgery, Department of Orthopaedics, University of Heidelberg, Schlierbacher Landstrasse 200 A, 69118, Heidelberg, Germany

    Markus Loew & Patric Raiss

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  1. Markus Loew
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  2. Patric Raiss
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Correspondence to Patric Raiss.

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Loew, M., Raiss, P. A symptom-based classification for shoulders with massive rotator cuff defects. International Orthopaedics (SICOT) 34, 63–69 (2010). https://doi.org/10.1007/s00264-009-0725-1

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  • DOI: https://doi.org/10.1007/s00264-009-0725-1

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