Treatment for Complications in a Degenerative Rotator Cuff Tear Caused by the Spur at the Greater Tuberosity of the Humerus

Abstract

The complications and MRI findings of 19shoulders in 17patients with the degenerative rotator cuff tears and the bony spur of more than 3 mm at the greater tuberosity were investigated. The average age was 71.3 (41-91). The presence of an effusion in the subacromial bursa, a nodular lesion on the synovial membrane and a thin portion of the deltoid muscle were evaluated by MRI images. Fourteen shoulders were treated conservatively and five were operated. Rotator cuff repairs with acromioplasty were done in all five shoulders and the spur excision and partial synovectomy were added in 1 and only spur excision in 2 shoulders. Complications were observed in 6 shoulders. Recurrent bleeding in the subacromial bursa (Idiopathic intraarticular hemorrhage of the shoulder joint) in 2, rupture of the deltoid muscle at the insertion in 2, severe knocked pain at the spur in 2 were observed. MRI images showed a massive effusion in 17 shoulders, nodular lesions of the synovial membrane in 5 and a thin portion of deltoid muscle in 3 shoulders. Postoperative results were good in all 5 shoulders. Intrasynovial hematoma of a subacromial bursa was observed pathologically in one shoulder with idiopathic intraarticular hemorrhage of the shoulder joint. Bony spurs at the greater tuberosity of the humerus with degenerative rotator cuff tears may cause an idiopathic intraarticular hemorrhage or a rupture of the insertion of deltoid muscles. The operative treatments of spur excision and partial synovectomy were recommended.