Long-Term Results of Subacromial Smoothing Without Acromioplasty for the Treatment of Irreparable Rotator Cuff Tears

Authors: Farrell et al.

References: Presented at AAOS 2003

Introduction: We previously presented our short-term results on the use of subacromial smoothing, resecting the hypertrophic subacromial bursa, rotator cuff insertion remnant, and osseous hypertrophy at the greater tuberosity without acromioplasty. We now present our long-term results. Methods: The initial review consisted of 14 patients (8 males, 6 females). For each patient, an age and gender matched control who underwent a rotator cuff repair during the same period was chosen. Both groups were evaluated both preoperatively and at two to five years postoperatively using the SF-36 and Simple Shoulder Test (SST). A repeat SST was then performed on ten of the fourteen patients in both groups at 5 to 7.5 years. Results: Analysis of the short-term vs. long-term SST revealed that following rotator cuff repair, comfort level did not diminish (91.7% vs. 95%), ability to perform overhand throw improved slightly (41.7% vs. 60%), and ability to lift eight pounds to shoulder level remained similar (41.7% vs. 40%). The subacromial smoothing patients continued to experience good comfort level over time (80% vs. 85%), poor ability to perform an overhand throw (23.1% vs. 30%), and good across body range of motion (92.3% vs. 90%). Interestingly, 50% of patients reported they could now lift 8 pounds to shoulder level compared to 15.4% in the short term. Conclusion: Subacromial smoothing without acromioplasty is an effective treatment option for patients with irreparable tears of the rotator cuff. The benefits of pain relief and continued function of the extremity do not decrease over the long term.

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