Long-tem clinical and ultrasound evaluation after arthroscopic acromioplasty in patients with partial rotator cuff repairs

Authors: J. Kartus'' C. Kartus L. Rostgård, N. Sernert . Read, M. Perko

References: SECEC 2005

Abstract
AIMS: To perform long-term clinical and ultrasound evaluation of patients who had undergone debridement of a partial rotator cuff tear in conjunction with an arthroscopic acromioplasty.

MATERIAL: Thirty-three consecutive patients were included in the study. Twenty-six/33 (79%) of the patients underwent ultrasound evaluation of both shoulders and were examined by independent observers after a follow-up period of 101 (60-128) months (minimum 5 years).

RESULTS: The median time between the onset of the symptoms and operation was 24 (6-360) months. At follow-up the Constant score was 65 (15-98) points. The Constant score on the contra lateral side was 84 (15-96) points, (p<0.00001). The strength in abduction was 4.7 (1.2-11.1) kg on the operated side and 5.1 (1.8-10.4) kg on the contra lateral side, (n.s.). Twelve/26 patients registered discomfort or pain in the contra lateral shoulder and during the follow-up period and 3/26 had undergone an arthroscopic acromioplasty of the contra lateral shoulder. Two/26 patients underwent further surgery of the index shoulder was 20 mm (0-85). The ultrasound evaluation revealed that 9/26 patients had a full thickness rotator cuff tear in the index shoulder and of these 3/9 were bilateral.

CONCLUSION: It appears that an arthroscopic acromioplasty and cuff debridement in patients with partial tears does not protect the rotator cuff from undergoing further degeneration. This indicates that continued failure is caused by a degenerative process in the rotator cuff itself, rather than by extrinsic mechanical factors.