Reversed arthroscopic subacromial decompression for symptomatic irreparable rotator cuff tears: mid-term follow-up results in 34 shoulders
| Autor: | Luk Verhelst, Pieter-Jan Vandekerckhove, Koen Liekens, Petrus Van Hoonacker, Bart Berghs, Gregory Sergeant |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Shoulders medicine.medical_treatment Tenotomy Arthroscopy Rotator Cuff medicine Humans Orthopedics and Sports Medicine Rotator cuff Acromion Range of Motion Articular Aged Retrospective Studies medicine.diagnostic_test Rupture Spontaneous business.industry Shoulder Joint General Medicine Surgery Radiography medicine.anatomical_structure Treatment Outcome Debridement Cuff Disease Progression Tears Female Joint Diseases Range of motion business Follow-Up Studies |
| Zdroj: | Journal of shoulder and elbow surgery. 19(4) |
| ISSN: | 1532-6500 |
| Popis: | In the elderly, there is no guideline for the treatment of irreparable rotator cuff lesions. The results of open or arthroscopic repair are variable. We hypothesized that the use of a reversed arthroscopic subacromial decompression (RASD) would yield comparable results.Between January 2004 and December 2006, thirty-eight patients underwent a RASD for irreparable cuff tears in 39 shoulders. The surgical procedure consisted of a tenotomy of the long head of the biceps tendon, a debridement of the torn rotator cuff and a tuberoplasty, without violation of the coracoacromial arch and the acromion.Thirty-three patients (age 69.9 +/- 7.3 years) were available for clinical and radiological evaluation of 34 shoulders (male/female ratio: 11/22), at a mean follow-up of 38 months (range: 21 months-52 months). Two of 33 patients had required revision surgery, and were excluded from further statistical analysis. In the remaining 31 patients (32 shoulders), the modified Constant-Murley score (CMS) improved from 34.9% +/- 11.6 to 84.0% +/- 11.6 (p0.0001). The preoperative mobility did not correlate with the final result. Preoperative pain was found to correlate negatively to the modified CMS at follow-up (p= 0.0038). Although the acromiohumeral height decreased with 2.58 mm +/- 1.68 and the severity of glenohumeral osteoarthritis increased with one grade (Samilson-Prieto classification), there was no correlation with the functional outcome.We conclude that for irreparable rotator cuff tears in the elderly, excellent mid-term results can be achieved with a RASD. |
| Databáze: | OpenAIRE |
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