Abstract
This study looks at the outcomes of 112 full thickness rotator cuff tears treated by arthroscopic decompression, without repair of the rotator cuff, from 1994. The decision not to repair the tear was taken only if four criteria were met. First, if there was no clinical weakness on manual testing of the individual rotator cuff muscles, secondly, if there was full abduction, thirdly, if there was no riding up of the humeral head on the anteroposterior radiograph and fourthly, if there was well-developed ‘cable’ on arthroscopic visualisation of the rotator cuff.
The mean age of the patients, 38% of whom were men, was 62 years (47 to 83). In 44% the right shoulder was operated on. There were 32% type-II acromions and 68% type-III. There were 58% C2 tears and 42% C3 tears. All had arthroscopic acromioplasty and acromioclavicular joint excision. Later, three required an open acromioclavicular joint excision with one open cuff repair. At a mean follow-up time of 71 months (11 to 110), the clinical and surgical notes and radiographs were reviewed and a modified Simple Shoulder Test (SST) used to evaluate outcomes by telephone. The mean postoperative SST was 11.5 out of 12 (3 to 12). Complete relief was reported in 84% of cases. These subjective results suggest that, with careful selection, not all full thickness tears of the rotator cuff need repair.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
