2009 Volume 33 Issue 2 Pages 411-414
The aim of the present study was to evaluate the medium term clinical outcome and cuff integrity examined with MRI after the operative treatment with open acromioplasty for pacial-thickness rotator cuff tear (PTRCT). 21 patients were included in this study. Types of PTRCT were articular-side tears (AST) in 3 patients (Ellman's grade Ia only), bursal-side tears (BST) in 16 patients (Ellman 's grade Ib : 8 patients, grade IIb : 4 patients, grade IIIb : 4 patients) and intratendenous tear (IT) in 2 patients. By a single shoulder surgeon, 11 patients (Ellman's grade Ia and Ib) underwent debridement, 6 patients (Ellman grade IIb & IT) underwent rotator cuff side to side suture, and 4 patients (Ellman's grade IIIb) underwent rotator cuff repair with suture anchor. All patients underwent open acromioplasty. We evaluated clinical outcome according to the Japanese Orthopaedic Association (JOA) score, Constant score and DASH, and examined the rotator cuff integrity according to Sugaya's postoperative MRI classification. The average follow-up term in this study was 7.5 years (range 6.0 to 9.1). The average JOA score, Constant score and DASH were 94.7 points (range 75.5 to 100), 84.2 points (range 64 to 98) and 5.6 points (range 0 to 25), respectively. Retear (Sugaya's classification type IV & V) was observed in 2 patients. Sugaya's classification type III and IV were observed in Ellman's grade II and III. In this study, the clinical outcome of treatment of PTRCT was as good as the results of previous studies. MRI showed that postoperative PTRCTs maintained good cuff integrity at mid-term follow-up. Degree and location of cuff tear might be associated with postoperative cuff integrity.
