Operative repair of massive rotator cuff tears: Long-term results.

Sixty-one patients had operative repair of a massive rotator cuff tear and were followed an average of 7 years (range 3 to 13 years). The mean age of the patients was 62 years; there were 40 male and 21 female patients. All patients had significant pain, 31 patients had insidious onset of pain, and 30 patients recalled a traumatic event. Preoperatively, average active forward elevation was 88°, and average active external rotation was 27°. Forty-nine (80%) patients had marked atrophy of the supraspinatus and infraspinatus muscles. All patients had subacromial decompression as well as mobilization and transposition of rotator cuff tendons with tendon repair to bone. Fifty-two (85%) patients had satisfactory results, with 32 (52%) rated excellent and 20 (33%) rated good. Nine (15%) patients had unsatisfactory results, with four (7%) rated fair and five (8%) rated poor. Ninety-two percent of patients had satisfactory pain relief. The mean gain in forward elevation was 76%, and in active external rotation it was 30°. Adequate pain relief and the ability to raise the arm above the horizontal plane were achieved in 56 (92%) patients. Two patients tore their rotator cuff again after significant trauma.