Outcome of arthroscopic repair of high-grade, bursal-sided, partial rotator cuff tears (SS-04)

Abstract

The natural history of the high-grade, partial tear of the bursal surface of the rotator cuff is not clearly understood. Recent evidence suggests that arthroscopic subacromial decompression or debridement alone can lead to poor outcome and may allow further deterioration of the rotator cuff. These tears may be particularly well-suited for an arthroscopic repair because of the presumably lower fixation demands afforded by the intact portion of the rotator cuff. We sought to evaluate the outcome of patients who’ve undergone arthroscopic repairs of high-grade bursal-sided rotator cuff tears. Methods: Between January 2000 and December 2002, 27 patients who had an intact articular surface, but a high-grade bursal-sided tear (>7 mm of exposed tuberosity) were treated with a subacromial decompression and an arthroscopic rotator cuff repair. All patients had a single row repair with at least one suture anchor. No lesion was completed to a full-thickness tear. Outcomes were assessed by serial examination and the L’Insalata shoulder rating questionnaire. Results: Mean follow-up was 24.5 months. 24 of the 25 patients were satisfied. L’Insalata scores increased from 34.7 to 85.1 (P < .001). Analysis of variance showed significant increases in abduction postoperatively (P = .004). Internal and external rotations were not significantly altered. Conclusions: Arthroscopic repair of high-grade, bursal-sided rotator cuff tears offer a high degree of patient satisfaction and functional improvement with low surgical morbidity. These outcomes appear to be favorable to previous reports of arthroscopic decompression and/or debridement. The natural history of the high-grade, partial tear of the bursal surface of the rotator cuff is not clearly understood. Recent evidence suggests that arthroscopic subacromial decompression or debridement alone can lead to poor outcome and may allow further deterioration of the rotator cuff. These tears may be particularly well-suited for an arthroscopic repair because of the presumably lower fixation demands afforded by the intact portion of the rotator cuff. We sought to evaluate the outcome of patients who’ve undergone arthroscopic repairs of high-grade bursal-sided rotator cuff tears. Methods: Between January 2000 and December 2002, 27 patients who had an intact articular surface, but a high-grade bursal-sided tear (>7 mm of exposed tuberosity) were treated with a subacromial decompression and an arthroscopic rotator cuff repair. All patients had a single row repair with at least one suture anchor. No lesion was completed to a full-thickness tear. Outcomes were assessed by serial examination and the L’Insalata shoulder rating questionnaire. Results: Mean follow-up was 24.5 months. 24 of the 25 patients were satisfied. L’Insalata scores increased from 34.7 to 85.1 (P < .001). Analysis of variance showed significant increases in abduction postoperatively (P = .004). Internal and external rotations were not significantly altered. Conclusions: Arthroscopic repair of high-grade, bursal-sided rotator cuff tears offer a high degree of patient satisfaction and functional improvement with low surgical morbidity. These outcomes appear to be favorable to previous reports of arthroscopic decompression and/or debridement.