Large to massive rotator cuff tears are challenging conditions in shoulder surgery and frequently it is impossible to repair completely even with the advancement of the knowledge and repair technique. For those irreparable rotator cuff tears, several alternative treatment options can be considered. Among them partial repair (so-called force couple repair) has gained some popularity in that it can be lead to pain relief and functional improvement. The purpose of this study was to report the preliminary clinical and radiographic results of arthroscopic force couple repair for the irreparable rotator cuff tears.
From June 2005 to February 2008, 101 large to massive rotator cuff patients were arthroscopically operated. Among them sixteen cases of force couple repair (posterior cuff repair with or without repair of upper portion of subscapularis) for the irreparable rotator cuff tears were available in evaluation. Clinical assessments were done at final follow-up with pain visual analogue scale (PVAS) and American Shoulder and Elbow Surgeons' (ASES) score. Postoperative acromiohumeral distance and arthritic change were compared with the preoperative plain radiographs.
The mean follow up was 27.3 months (15∼46) and the mean age was 66.6 years (57∼76). There were 7 male and 9 female patients. PVAS and ASES score was improved from 4.4 (±2.5) and 39.0 (±10.8) to 2.1(±2.3) and 80.3 (±16.8) (p=0.003 and 0.002, respectively). Three patients rated excellent, 9 patients rated good, 3 patients rated fair, and one patient rated poor. Acromiohumeral distance was measured as 6.6 (±1.7) mm preoperatively and 6.2 (±1.7) mm postoperatively. There was no statistical difference (p=0.387). Degenerative change by Hamada classification was not progressed postoperatively (p=0.201).
Partial repair for the irreparable rotator cuff tear showed good clinical results and no progression of acromiohumeral distance and degenerative change at mean 2.3 years after surgery.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.