Background: Previous studies of the effect
of rotator cuff surgery have concentrated on limb-specific or surgeon-based
outcome criteria. We conducted a prospective trial to determine
the effect of surgery for rotator cuff disease on general health
Methods: Seventy-one patients (fifty of whom
were men and twenty-one of whom were women) with a mean age of 56.1
years were enrolled in the study. In addition to routine clinical
and radiographic evaluation, all patients completed the Short Form-36
(SF-36) health-status questionnaire and five limb-specific questionnaires
preoperatively and at six, twelve, eighteen, and twenty-four months postoperatively.
All patients had a standard open acromioplasty and resection of
the subacromial bursa. Thirty-one patients had repair of an associated
rotator cuff tear. Sixty-seven patients (94 percent) completed the
study; the remaining four patients were lost to follow-up.
Results: The preoperative SF-36 scores for physical
function (60.6, p = 0.02), role function-physical (20.8, p = 0.001),
pain (38.6, p = 0.003), physical component summary (37.0, p = 0.001),
and mental component summary (45.6, p = 0.02) were significantly
decreased compared with normative data. The preoperative limb-specific
scores also were low. At the time of the most recent follow-up evaluation,
there was improvement that approached or reached significance both
in the limb-specific scores (p Â£ 0.0026) and in the general-health-status
scores for pain (p = 0.0001), role function-physical (p = 0.06),
vitality (p = 0.01), and physical component summary (p = 0.01).
The presence of a rotator cuff tear had a significant negative effect
on limb-specific scores both preoperatively (p = 0.04) and postoperatively
(p = 0.05). Although operative treatment of rotator cuff disease
led to improved scores, patients who had filed a Workers' Compensation
claim had lower limb-specific and SF-36 scores both preoperatively
(p = 0.02 and p = 0.01, respectively) and postoperatively (p = 0.01
and p = 0.005, respectively).
Conclusions: Surgery for chronic rotator cuff
disease reliably and significantly improves general health status.