Among patients with massive rotator cuff tears with irreparable supraspinatus and infraspinatus tendons, arthroscopic subscapularis-only repair and greater tuberoplasty may offer a promising and safe method for treatment, according to study results.
Forty-one patients who underwent arthroscopic subscapularis-only repair and greater tuberoplasty between April 2003 and August 2009 for massive three-tendon cuff tears with irreparable supraspinatus and infraspinatus tendons after 3 months of conservative management was unsuccessful were retrospectively investigated. Sixty-one percent of patients underwent biceps tenotomy, and 39% had preexisting biceps tenotomy or rupture. The researchers assessed the patients using American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores. After a minimum of 12 months, 83% of patients were available for a follow-up telephone questionnaire.
Results showed a mean ASES score of 76% and a mean SANE score of 63%. The researchers also found mean postoperative passive range of motion was 156° of forward flexion and 39° of external rotation.
Additionally, 74% of the patients queried were able to actively raise their arms above should level, and 22 of 27 patients who had a positive belly-press test result preoperatively had a negative test result postoperatively.
Overall, three complications occurred, and workers’ compensation claim was a strong predictor of lower shoulder scores, according to the researchers.
Disclosure: Austin is a paid consultant for Tornier and his institution, the Rothman Institute, receives grants from Zimmer. Lazarus is a paid consultant for and receives royalties from Tornier.