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

Abstract

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. 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. 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. 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.