Reversed arthroscopic subacromial decompression for symptomatic irreparable rotator cuff tears: Mid-term follow-up results in 34 shoulders

In the elderly, there is no guideline for the treatment of irreparable rotator cuff lesions. The results of open or arthroscopic repair are variable. We hypothesized that the use of a reversed arthroscopic subacromial decompression (RASD) would yield comparable results. Between January 2004 and Dece...

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Veröffentlicht in:Journal of shoulder and elbow surgery Jg. 19; H. 4; S. 601 - 608
Hauptverfasser: Verhelst, Luk, Vandekerckhove, Pieter-Jan, Sergeant, Gregory, Liekens, Koen, Van Hoonacker, Petrus, Berghs, Bart
Format: Journal Article
Sprache:Englisch
Veröffentlicht: New York, NY Mosby, Inc 01.06.2010
Elsevier
Schlagworte:
38 months follow-up
Acromion
Aged
Arthroscopy
Arthroscopy - methods
Biological and medical sciences
Debridement - methods
Disease Progression
Diseases of the osteoarticular system
elderly patient
Endoscopy
Female
Follow-Up Studies
Humans
Investigative techniques, diagnostic techniques (general aspects)
irreparable cuff tear
Joint Diseases - diagnostic imaging
Joint Diseases - surgery
Juxtaarticular diseases. Extraarticular rhumatism
Male
Medical sciences
Orthopedics
Radiography
Range of Motion, Articular
Retrospective Studies
Reversed arthroscopic subacromial decompression
Rotator Cuff - diagnostic imaging
Rotator Cuff - surgery
Rupture, Spontaneous
Shoulder Joint - diagnostic imaging
Shoulder Joint - physiopathology
Shoulder Joint - surgery
Time Factors
Treatment Outcome
Treatment Study
elderly patient
Retrospective Case Series
Level IV
irreparable cuff tear
38 months follow-up
Reversed arthroscopic subacromial decompression
Juxtaarticular disease
Symptomatology
Arthroscopy
Rotator cuff rupture
Shoulder
Diseases of the osteoarticular system
Rheumatology
Endoscopy
ISSN:1058-2746, 1532-6500, 1532-6500
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Zusammenfassung:In the elderly, there is no guideline for the treatment of irreparable rotator cuff lesions. The results of open or arthroscopic repair are variable. We hypothesized that the use of a reversed arthroscopic subacromial decompression (RASD) would yield comparable results. Between January 2004 and December 2006, thirty-eight patients underwent a RASD for irreparable cuff tears in 39 shoulders. The surgical procedure consisted of a tenotomy of the long head of the biceps tendon, a debridement of the torn rotator cuff and a tuberoplasty, without violation of the coracoacromial arch and the acromion. Thirty-three patients (age 69.9 ± 7.3 years) were available for clinical and radiological evaluation of 34 shoulders (male/female ratio: 11/22), at a mean follow-up of 38 months (range: 21 months–52 months). Two of 33 patients had required revision surgery, and were excluded from further statistical analysis. In the remaining 31 patients (32 shoulders), the modified Constant-Murley score (CMS) improved from 34.9% ± 11.6 to 84.0% ± 11.6 (p < 0.0001). The preoperative mobility did not correlate with the final result. Preoperative pain was found to correlate negatively to the modified CMS at follow-up (p= 0.0038). Although the acromiohumeral height decreased with 2.58 mm ± 1.68 and the severity of glenohumeral osteoarthritis increased with one grade (Samilson-Prieto classification), there was no correlation with the functional outcome. We conclude that for irreparable rotator cuff tears in the elderly, excellent mid-term results can be achieved with a RASD.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:1058-2746
1532-6500
1532-6500
DOI:10.1016/j.jse.2009.10.001