OPEN SURGERY FOR ROTATOR CUFF REPAIR

Abstract

Introduction and Objectives: Among the pathological conditions associated with the subacromial space is rupture of the rotator cuff. Patients affected by this injury have a poorer response to medical or rehabilitative treatment than do patients with subacromial injuries without concurrent tearing of the rotator cuff. For this reason, surgical treatment is more often needed. Surgical treatment includes the excision of subacromial osteophytes and repair of the affected tendon. Even though acromioplasty can be performed arthroscopically, cuff repair generally requires small incisions due to the technical complexity of the procedure.

Materials and Methods: We have carried out a prospective study of 36 patients with torn rotator cuffs diagnosed by MRI who underwent acromioplasty performed with an incision of approximately 4cm when necessary and cuff repair either by direct suturing or reinforcement with rotator cuff plasty performed by the same surgeon. The rehabilitation protocol included early mobilisation at 24–48 hours, passive assisted mobilisation until the 4th week, and active mobilization after the 5th week. Follow-up time was a minimum of one year with pre- and postoperative Constant scale evaluations. We compared various results including previous duration of symptoms, the severity of cuff tearing, and the surgical technique that was used.

Results: Favorable results were achieved in terms of pain relief and restoration of mobility compared to the preoperative period, even though strength was not equal to that of the contralateral shoulder.

Discussion and Conclusions: Open surgery for rotator cuff tear repair continues to be the best surgical option if a small incision is made, good technique used, and early rehabilitation is performed.