Treatment of Massive Irreparable Rotator Cuff Tear with Arthroscopic Subacromial Bursectomy, Biceps Tenotomy, and Tuberoplasty

Abstract

Background: The alternative surgery for massive and irreparable shoulder rotator cuff tears in older patients is the<br />debridement of subacromial bursa, biceps tenotomy, and tuberoplasty (reverse acromioplasty). This study aimed to<br />report the effectiveness of such a treatment performed arthroscopically in a small group of patients for a short period<br />of time.<br />Methods: This prospective study was conducted on 12 patients with massive irreparable rotator cuff tear during 2014-<br />2017. Participants with the mean age of 65 were subjected to arthroscopic debridement of subacromial bursa, necrotic<br />rotator cuff tendon remnants, and tuberoplasty without coracoacromial ligament excision. The sign and symptoms of<br />patients before and after the surgery were evaluated based on Modified-University of California at Los Angeles (UCLA)<br />Shoulder Score.<br />Results: With the mean follow-up of 18 months (12-24 months), the mean of the modified UCLA score improved from<br />9.2 to 27.5. The obtained results of the study revealed that the pain and range of motion improved to near normal in the<br />participants. The functional outcome was good although there were a decrease of acromiohumeral distance from 5 to<br />4 mm and a slight increase in degenerative changes.<br />Conclusion: This simple arthroscopic procedure is recommended for massive irreparable rotator cuff tear, especially<br />in elderly patients.<br />Level of evidence: IV