Functional outcome of partial arthroscopic repair for massive rotator cuff tears

BackgroundDespite advancement in arthroscopic techniques, surgical management of massive, irreparable rotator cuff can be difficult and demanding. Hence different surgical options like debridement, cuff augmentation, partial repair, tendon transfer, reverse shoulder arthroplasty or in space balloon spacer following failure of non-operative treatment have been described in literature.AimTo evaluate functional outcome following arthroscopic partial repair in patients with pseudo paralysis as result of massive irreparable rotator cuff.Material and MethodsRetrospective review 19 patients with arthroscopic partial repair for massive rotator cuff tear performed. The diagnosis of massive cuff tear was confirmed in all patients during arthroscopic evaluation. Arthroscopic partial cuff repair was performed if watertight repair not possible in all cases to restore the insertion of the cuff above the equator. The postoperative scores were recorded by a postal questionnaire.ResultsThere were 13 male and 6 female in this group with an average age of 60.4 years. Average follow up was 10.42 months (3-24 months). At follow up 14/19 (73%) had more than 900 forward flexion, abduction and 4/19 had external rotation greater than 450. Postop scoring was available in 11 patients with average oxford score 33.3 (19-44) and Quick DASH score of 22.16 (2.3-63.6). Pain levels were improved in all 11 patients who completed the questionnaire. Preoperative pseudo paralysis was improved in 82.3% patients (14/17). We had 2 patients presenting with re rupture 8 and 20 months respectively. None of the patients had reoperation within 2 years of primary procedure.ConclusionFunctional partial repair can restore the shoulder biomechanics. The Partial cuff repair along with robust deltoid rehabilitation is a reliable procedure with good functional outcome.