Taking a Closer Look at Repairing Large Rotator Cuff Tears

Authors: Christopher K. Jones, MD, and Felix H. Savoie III, MD.

References: Arthroscopy. July-August, 2003. Vol. 19. No. 6. Pp. 564-571.

Police talk about cases as being open and closed. It means the case was solved quickly. When orthopedic surgeons talk about open and closed, it means something entirely different.

Arthroscopy has changed many operations from being open (meaning that surgery involves a large incision) to closed (meaning that surgery involves only one or two tiny puncture holes). The arthroscope is a tool that allows the doctor to look inside a joint and even do repairs without ever opening the joint.

Using an arthroscope is still a fairly new operation for a torn rotator cuff in the shoulder. Studies comparing rotator cuff repairs with or without arthroscopy are underway. This study looked at 50 patients with large tears. All were repaired using an arthroscope.

These doctors from Georgia and Mississippi joined together to look at the results of arthroscopic repair of large rotator cuff tears. Success was measured using pain, function, range of motion, strength, and patient satisfaction. Patient responses were given number ratings. The results were ranked as excellent, good, fair, or poor. Most patients in this study had a good or excellent outcome. The results are similar to other studies of small- to medium-sized tears. Patients were followed for at least a year and sometimes as long as five years.

The results are important because there's so much debate over the treatment of large tears. Some doctors think arthroscopic repair can't be done with good results. Others suggest cleaning up the area of injury but not repairing the tear.

The authors conclude that a perfect repair of a large rotator cuff tear isn't needed for an excellent result. Arthroscopy can be used to restore normal mechanics of the shoulder even in large tears. They think that most tears of any size can be repaired this way.

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