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. 2015 Apr;7(2):94-9.
doi: 10.1177/1758573214557144. Epub 2014 Oct 30.

Arthroscopic suprascapular neurotomy for the painful irreparable rotator cuff tear

Peter Kenyon  1 , Iain Mclaughlin-Symon  2 , Richard Heasley  3 , Barnes Morgan  2 , Matt Ravenscroft  2
Affiliations

Arthroscopic suprascapular neurotomy for the painful irreparable rotator cuff tear

Peter Kenyon et al. Shoulder Elbow. 2015 Apr.

Abstract

Background: Massive irreparable rotator cuff tears are becoming increasingly difficult to manage.

Methods: Patients were considered for treatment if they had a painful shoulder in the presence of a compensated cuff tear. All patients had radiological evidence of a massive irreparable cuff tear and underwent suprascapular neurotomy, arthroscopically.

Results: There were 15 males and 25 females with a mean age of 74 years (range 59 years to 88 years). The mean pre-operative Oxford Shoulder Score (OSS) in all patients was 17.7, with a mean pre-operative visual analogue score (VAS) of 8.0. The mean post-operative OSS was 30.8 [27.42-34.18 = confidence interval (CI) 95%] with a mean VAS of 3.6 (2.64-4.56 CI 95%) at the 3-month (short-term) period (n = 32). The medium-term (1-year) OSS and VAS had improved to 33.6 (32.27-34.93 = CI 95%) and 3.7 (0-8.39 CI 95%) respectively (n = 26). The difference pre- and postoperatively at 12 months was statistically significant (p < 0.001). Patients who underwent biceps tenotomy at the time of surgery had a less significant improvement in their VAS and OSS.

Conclusions: Suprascapular neurotomy can afford medium-term benefit in over two-thirds of the patients who would otherwise have undergone reverse polarity shoulder replacements. We consider that this is a reproducible technique.

Keywords: Arthroscopy; rotator cuff; rotator cuff arthropathy; suprascapular nerve.

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Figures

Figure 1.
Figure 1.
Components contributing to the diagnosis of an irreparable rotator cuff.
Figure 2.
Figure 2.
Arthroscopic identification of the right suprascapular notch ligament and nerve as seen from a lateral viewing portal.
Figure 3.
Figure 3.
Schematic diagram of a posterior coracoid.
Figure 4.
Figure 4.
Oxford Shoulder Score breakdown following suprascapular nerve ablation.
See this image and copyright information in PMC

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