Partial repair of irreparable supraspinatus tendon tears: clinical and radiographic evaluations at long-term follow-up

• Published in: Journal of shoulder and elbow surgery 2011-10, Vol.20 (7), p.1170-1177
• Main Authors: Porcellini, Giuseppe, MD, Castagna, Alessandro, MD, Cesari, Eugenio, MD, Merolla, Giovanni, MD, Pellegrini, Andrea, MD, Paladini, Paolo, MD
• Format: Article
• Language: English
• Subjects: Acromion - pathology; Aged; arthroscopic surgery; Arthroscopy - methods; Biological and medical sciences; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; Humerus - pathology; Injuries of the limb. Injuries of the spine; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Orthopedics; Partial rotator cuff repair; Patient Satisfaction; Rotator Cuff - pathology; Rotator Cuff - surgery; Rotator Cuff Injuries; supraspinatus atrophy; Suture Anchors; Tenotomy; Traumas. Diseases due to physical agents; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2010.11.002

Background Irreparable rotator cuff tears are a common source of pain and disability even in middle-aged patients. Although most rotator cuff tears can be completely repaired to bone, a significant proportion of these cannot be sutured by traditional methods. In these cases it is possible to perform a functional repair of the cuff to help restore the force couple of the cuff on the humeral head and to increase the acromion-humeral distance (AHD). This technique provides peripheral repair of the cuff tear without complete closure of the cuff defect. Our hypothesis was that arthroscopic partial suture of the cuff leads to pain relief and functional improvement for the patients while restoring the AHD. Materials and methods All patients (67 cases) were arthroscopically treated with functional repair of the posterior cuff. The follow-up was at least 5 years. All the patients had clinical and radiographic evaluations and assessment with the Simple Shoulder Test and Constant score. Results The mean Constant score increased from 44 points to a mean of 73 points, the mean Simple Shoulder Test score increased from 4.6 to 9.0, and the mean AHD increased from 6.1 mm to 9.1 mm. Discussion and conclusion Functional repair of the infraspinatus, leaving the greater tuberosity uncovered, in patients with irreparable cuff tears gives good results in terms of patient satisfaction and in restoring the AHD even at long-term follow-up. Complications were rare and in line with the usual sequelae of a rotator cuff repair.