[Arthroscopic repair of full-thickness tears of the rotator cuff]

Abstract

Introduction: Shoulder arthroscopy was only at first a surgical technique for subacromial decompression and has been progressively extended to the cuff repairs. This surgery remains nevertheless difficult and requires to be described exactly. A multicenter study of the French Arthroscopic Society allowed to analyse and to underline the quality of the clinical and anatomical results.

Surgical technique: The technique is described exactly as well as the necessary material. Repair will be adapted to the size and the location of the tear. The technical skill should be simple, effective and reproducible to obtain the best anatomical result.

Results: The Constant score improved from an average 46.3 (13.4) to 82.7 (+/- 10.3) at the last follow-up, with 62% of patients' symptom free. Strength improved from 5.8 (+/- 3.7) to 13.6 (+/- 5.4). Ninety-four percent of the results were rated as excellent or good (Constant score >65). A watertight repair was found in 74.1% of the cases.

Discussion: Numerous correlations allow to confirm the results found in the literature: the healing of the cuff improves global functional results even when the tear is massive; anatomical result depends on the size of the initial tear; preoperative fatty degeneration is an important predictive factor; the healing of the cuff is related to the age. The quality of the results, the evolution of the material, the simplification and the codification of the surgical technique make it an accessible, effective reproducible surgery.