This study was designed to compare early functional outcomes in patients undergoing revision arthroscopic repair of massive rotator cuff tears retracted medial to the glenoid with Goutallier Grade 3B atrophy with and without arthroscopic release of the suprascapular nerve at the suprascapular notch. We hypothesized that patients undergoing concomitant nerve release would have more favorable functional outcomes at final follow-up as compared to those not undergoing release.
Twenty patients between the ages of 42 and 74 years (12 male, 8 female) underwent arthroscopic repair of a massive rotator cuff tears with concomitant arthroscopic release of the suprascapular nerve from June 2007 to December 2008. The Modified UCLA Shoulder Rating Scale for each patient was obtained both preoperatively and at final follow-up. These scores were compared to a similar group of twenty patients (age range 45-78 years; 14 male, 6 female) undergoing arthroscopic repair of massive rotator cuff tears without suprascapular nerve release during the same time period. Average time to final follow-up for all patients was 16.45 months (range 6-26 months). All procedures were performed and/or supervised by the senior attending surgeon (F.H.S.)
Modified UCLA Shoulder Rating Scale scores improved in both groups. Eighteen of twenty patients who underwent suprascapular nerve release were satisfied and recovered at least two grades of strength according to the Modified UCLA Shoulder Rating Scale. Pain scores also improved at least two grades in all patients in this group. In the comparison group, sixteen of twenty patients were satisfied. Strength improved an average of one grade and pain improved an average of one grade.
Our results demonstrate that patients undergoing release of the suprascapular nerve at the suprascapular notch at the time of revision repair of a massive rotator cuff tear retracted medial to the glenoid with Goutallier Grade 3B atrophy had significantly better functional outcomes. Although the indications for suprascapular nerve release are undetermined at present, this procedure improves the success rate in this group of patients.
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