Cuff-slight arthropaty: clinical assessment following open suture or fixation of the cuff or shoulder replacement

We analysed the functional outcome of patients with cuff- slight-arthropathy (CSA) who underwent surgery for pain and radiographically assessed prevalence of shoulder arthropathy in asymptomatic subjects. Osteophytes cystic changes and reduction of joint space (<2mm) are the radiographic requisites to consider arthropathy as slight, Thirty-five patients with CSA (Goutallier l- 2) who underwent open acromioplasty together with tendon repair/transosseous fixation (8), Hemarthor Plasty, (HA) (11) and total shoulder anthroplasrty (TSA) (4) were clinically assessed over a period of 3 years. We radiographically evaluated the contralateral shoulder of 110 subjects. Joint space was measured; prevalence of osteophytes and cystic changes was calculated, and the constant scores evaluated. Results: Pre-operative score of patients who urderwent Decompression+cuff suture/fixation. HA and TSA were, respectively. 36-32-30-28: the post-operative scores were 62-58-52-38. Factors that influenced the scores included incomplete pain relief but greater strength in those repaired without prostheses, and a limited ROM and strength in these replaced. Two patients with TSA had glenoid loosening. Joint-space in asymptomatics was 4.2± 1.3mm: osteophytes und cystic changes were observed in between 7.2%-12.7%. Conclusions: Outcomes following open decompression- +suture/fixation are generally satisfactory, although cuff failure may cause a decrease in scores. Patients must be informed regarding the possibility of a future replacement of the joint and that outcomes, after arthroplasty, are not so satisfactory as than those obtained in shoulders not previously operated upon. Pain relief was general after HA but without a satisfactory increase in ROM or strength. Patients with TSA frequently had unsatisfactory results attributed lo the "rocking-horse" phenomenon. Finally uncomplicated slight arthropathy does not produce pain.