Arthroscopic Debridement for Massive Rotator Cuff Tears

抄録

Purpose
It was difficult to repair a massive rotator cuff tear, so at first, we tried to apply the arthroscopic debridement on older cases with a massive rotator cuff tear. In this report, we evaluated the effects and problems of this method.
Patients
There were 19 cases (20 shoulders) with massive rotator cuff tears.11 males and 8 females were in the group, with the right shoulder involved in 14 cases, the left in 4 cases and both in one case. The average age was 70 years (range: 55-82). The average follow-up duration was 17.5 months (540 months).
Treatments
We did an arthroscopic observation, after which we carried out an arthroscopic debridement. One day after the debridement, early passive motion exercises were started, and one week after the debridement, active motion exercises started. After the treatment, all the patients were evaluated using the JOA shoulder score.
Results
In the JOA score, the average score at preoperation was 50.6, at discharge time 67.7 and at followup time 67.4.
The average scores at discharge and follow-up time were significantly better than that at preoperation. However, in 7 cases shoulder pain recurred and 6 cases without any, could not elevate their arms even after surgery. But,14 cases were satisfied with the results anyway.5 cases were unsatisfied.4 of these 5 cases were treated with open surgical repair, and 3 cases recovered.
Conclusion
Arthroscopic debridement is one of the useful first-aid treatments for inactive older cases with massive rotator cuff tears, but limited. Some patients need second cuff repair operations.