Abstract
The surgical technique for treatment of massive rotator cuff tears, more than 5 cm, with loss of substance and tendon retraction, is still not well defined by the international orthopaedic community. A specific rehabilitation regimen or arthroscopic débridement may be insufficient in active patients who continue to suffer from pain and muscular fatigue in active forward elevation. We treated 20 patients, 14 men and 6 women, with an average age of 52 years (range 40–69) with the surgical technique consisting in acromion decompression, stabilisation of the cuff lesion with anchors, application of a prolene membrane and using a deltoid muscular flap as reinforcement. Deltoid flap is created by splitting the deltoid muscular fibres in front of the anterior border of the acromion. The inferior part of deltoid is sutured to the tendon above the synthetic membrane.
The mean patient follow-up was 24 months. The pain was completely relieved in 85% of subjects, The joint mobility increased significantly in flexion, abduction and external rotation; however, the internal rotation did not improve.
We propose this surgical technique as the procedure of choice for treating retracted ruptures of the supraspinatus associated with lesions of the supra- and the infra-spinatus.
