RT Journal
A1 Hata, Yukihiko
A1 Saitoh, Satoru
A1 Murakami, Narumichi
A1 Kobayashi, Hirokazu
A1 Takaoka, Kunio
T1 Atrophy of the Deltoid Muscle Following Rotator Cuff Surgery
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2004
FD July 1
VO 86
IS 7
SP 1414
OP 1419
DO 
UL http://dx.doi.org/
AB Background: Less invasive procedures have recently been introduced
to facilitate an earlier return to sports or work activities after rotator
cuff repair. Few reports, however, have verified whether such procedures are
really less invasive than conventional open repair. The purpose of this study
was to compare the postoperative thickness of the deltoid muscle in patients
treated with either conventional or mini-open rotator cuff repair.Methods: Conventional open repair was performed from 1994 through
1997 in forty-three patients with rotator cuff tears. The mini-open
deltoid-splitting approach was introduced in 1997, and the cases of
thirty-five patients who underwent that procedure were reviewed. The two
groups were compared with respect to the thickness of the anterior fibers of
the deltoid muscle measured on the transverse magnetic resonance images, the
degree of active forward flexion, and the times required for return to work
and sports activities.Results: The thickness of the anterior deltoid fibers did not change
significantly after surgery in the mini-open repair group, whereas it was
significantly decreased in the open repair group at six months as well as at
twelve months postoperatively (p < 0.05). At three months postoperatively,
the mean University of California at Los Angeles score for active forward
flexion in the patients treated with the mini-open repair (4.9 points) was
significantly greater than that in the patients in the conventional open
repair group (4.6 points) (p < 0.05). In addition, the mean time-period
required for return to work in the mini-open repair group (2.4 months) was
significantly shorter than that required in the control group (3.4 months) (p
< 0.05).Conclusions: The mini-open repair appeared to cause less
postoperative atrophy of the deltoid muscle than did the conventional open
rotator cuff repair, and patients treated with the mini-open repair recovered
more quickly.Level of Evidence: Therapeutic study, Level III-2
(retrospective cohort study). See Instructions to Authors for a complete
description of levels of evidence.