Acute tears of the rotator cuff. The timing of surgical repair.

Thirty-seven patients had surgical repair within three months after significant ruptures of the shoulder rotator cuff. Twelve were repaired within three weeks (Group 1), six within three to six weeks (Group 2), and 19 within six to 12 weeks after injury (Group 3). Follow-up periods averaged 7.0 years (range, 1.25-21.00 years). Pain relief was generally satisfactory; however, active postoperative abduction averaged 168 degrees for Group 1, 126 degrees for Group 2, and only 129 degrees for Group 3. At open operation, the tear size was graded as small, medium, or large. The correlation of average values of postoperative abduction (148 degrees, 152 degrees, and 133 degrees) with tear size was not statistically significant. Roentgenograms showed that rotator cuff disease is associated with glenohumeral arthritis. With evidence of an acute and complete disruption of the rotator cuff if one must consider surgery, early surgical repair (with 3 weeks of injury) affords the best opportunity for maximal recovery of shoulder function.