Treatment of Massive Irreparable Rotator Cuff Tear with Arthroscopic Subacromial Bursa and Bicipital Tendon Decompression and Tuberoplasty

In massive irreparable shoulder rotator cuff tears in older patients an alternative surgery is debredement of subacromial bursa biceps tendon and tuberoplasty. This is a short-term report of such a treatment performed arthroscopically in a small group of patients. In a prospective study in a 2 year interval 8 patients with massive irreparable rotator cuff tear with mean age of 65 (60-75) underwent arthroscopic debridement of necrotic rotator cuff tendon remnants and tuberoplasty without coracoaromial ligament excision. The sign and symptoms of patients before and after surgery were evaluated with modified UCLA score. With a mean follow-up of 12 months (6-18 months) the modified UCLA score improved from 9.2 to 27.5. In 7 patients pain and range of motion improved to near normal and 6 cases obtained near normal function. Although the acromiohumeral distance decreased from 5 to 4 millimeters and slight increase in degenerative changes was observed the functional outcome was good. This simple arthroscopic procedure is recommended in massive irreparable rotator cuff tear especially in elderly patients.