Aim: The description of technique and early results of arthroscopic rotator cuff tears (RCT) reconstruction.

Patients-Methods: Âetween 01/2001 and 02/2003 26 patients, ranging in age from 33–82 (mean age 61,5 y.) – 17 males, 9 females – with RCT underwent arthroscopic reconstruction including debridement, sub-acromial decompression and mobilization of the rotator cuff. The RCT was then repaired with the arm in neutral position using “side to side” suturing technique and rotator cuff anchors when needed. Postoperatively, rehabilitation program included initially passive, active kinisiotherapy while exercises under resistance were finally performed..

Results: All patients were evaluated using ASES and UCLA scores pre-and postoperatively. Pain relief postoperatively was noticed in almost all reconstructed patients. In order to indentify functional improvement range of motion and strength were seperately evaluated. Range of motion just as pain remission was notably improved in almost all patients while strength ameliorate most in patients with complete restoration of rotator cuff tear. The interval between reconstruction and full patients’ recovery ranged between 3 months – pat. < 60 years – to 6–8 months – pat. > 60 years.

Conclusions: Arthroscopic RCT reconstruction although a demanding technique achieves satisfactory early results—mainly regarding pain relief and range of motion improvement- comparable to those of open repair reducing also postoperative morbidity.

Purpose of this report is to present a surgeons group experience in shoulder arthroscopy step by step from a diagnostic status to a therapeutic one, in cases of recurrent instability, impingement syndrome and rotator cuff pathology. There is focus on technique tips, learning curve period, complications and solutions.

We evaluated 250 shoulder arthroscopies from May 99 to Apr.03. 155 cases of them were recurrent instability reconstructions in young patients (16–34 years old, ave.24,3) while the rest of them were rotator cuff pathology patients (22–69 years old ave.44,3). Lateral decubitus position was elected as the standard position in all cases. Patients were operated from a group of two surgeons each time. We analyzed parameters as, EUA, learning curve, technique tips concerning labrum mobilization, anchors and shuttle relay insertion and capsule plication. We describe the intra-op complications and the way out of them. There is also a detection where arthroscopic shoulder instability reconstruction was contraindicated and open technique was preferred.

Our experience in arthroscopic shoulder instability reconstruction and rotator cuff pathology showed that, is a minimally invasive technique. The learning curve period is high, better results can be anticipated when there is a surgical group and when there is a carefully elected sample of patients as it was in our cases.