[The results of arthroscopic repair of full-thickness tears of the rotator cuff].

OBJECTIVES

This study was designed to evaluate the functional results of arthroscopic repair of full-thickness tears of the rotator cuff and to investigate the degree of fatty degeneration of the rotator cuff muscles and recurrent ruptures by magnetic resonance imaging (MRI).

METHODS

Twenty-two patients (9 males, 13 females; mean age 56 years; range 38 to 71 years) underwent arthroscopic repair of full-thickness tears of the rotator cuff following conservative treatment for a mean of 15 months (range 45 days to 120 months). Involvement was in the right shoulder in 17 patients, being on the dominant side in 77%. The range of motion was measured with a goniometer, and muscle strength by manual examination. Clinical and functional evaluations were made by physical examination and according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and the UCLA scale. Fatty degeneration of the rotator cuff muscles and recurrence were analyzed by MRI. The mean follow-up was 24 months (range 12 to 36 months).

RESULTS

The mean active forward flexion and external rotation increased from 105 degrees to 160 degrees (p<0.05) and from 41 degrees to 44 degrees (p>0.05), respectively. The strength of the supraspinatus and infraspinatus muscles significantly increased (p<0.05). The mean ASES and UCLA scores significantly increased from 25.4 to 86.7 and from 10.6 to 25.6, respectively (p<0.05). The mean healing time was three months (range 1 to 12 months). Twenty patients (90.9%) were satisfied with the result of the treatment. On MRI scans, recurrent ruptures were detected in seven patients (31.8%); the extent of fatty degeneration of the rotator cuff muscles did not differ pre- and postoperatively (p>0.05).

CONCLUSION

Arthroscopic repair of full-thickness tears of the rotator cuff yields high clinical and functional success rates.