Summary
repair of massive and irreparable rotator cuff tear is very challenging but could be a one of proper substitution of arthroplasty or tendon transfer.
Abstract
Introduction
Repair of massive and irreparable RCT is technically very challenging. There were several methods for resolving this conundrum including reverse shoulder arthroplasty.
In the view of force coupling theory, if subscapularis tendon is robust, partial repair of arthroscopic supraspinatus or infraspinatus tendon procedure would decrease patient’s pain and increase shoulder function. We hypotheses that arthroscopic partial repair and balancing of massive rotator cuff tear may take good shoulder scoring and VAS of pain.
Methods
Over a thirty eight months period, 15 cases of Massive and over grade 3 of Goutallier fatty degeneration rotator cuff tear partial repair were followed. Clinical outcomes assessment included American Shoulder and Elbow Surgeons ( ASES) score, Constant score and visual analog pain scale were measured at six weeks, 3mos, one year, two years and final 4yrs.
Results
There were significant differences of ASES score, CS and VAS pain score on 6 weeks, 3months, 6months, 1 year, 2 years and 4years follow up compare with preoperative state. The 2 years and 4 years score was quite comparable with conventional arthroscopic RC repair procedure. Two patients had re-tear of Rotator cuff and re-operation. One of them had Reverse shoulder arthroplasty after arthroscopic re-repair try.