Scoping Out the Results of Large Rotator Cuff TearsArthroscopy has changed many joint operations from being "open" (with a large incision) to "closed" (with only one or two tiny puncture holes). The arthroscope is a tool used in closed surgeries. It allows the doctor to look inside a joint and even do repairs without ever opening the joint.
Using an arthroscope to repair a torn rotator cuff in the shoulder is still fairly new. Studies comparing rotator cuff repairs with or without arthroscopy are
underway. Some doctors think arthroscopic repair can't be done with good results. Others suggest just cleaning up the area of injury, without repairing the tear.
This study looked at 50 patients with large tears. All were repaired with an arthroscope. Several doctors recently joined together to look at the results of arthroscopic repair of large rotator cuff tears. Success was measured using pain, function, range of motion, strength, and patient satisfaction. Patient responses were given number ratings. The results were tallied to get an excellent, good, fair, or poor result.
Most patients in this study had a good or excellent outcome. The results are similar to other studies of small- to medium-sized tears. Patients were followed for at least a year and sometimes as long as five years. The results are important because there's so much debate over the best treatment of large tears.
The authors conclude that a perfect repair of a large rotator cuff tear isn't needed for an excellent result. Arthroscopy can be used to restore normal mechanics of the shoulder even in large tears. They think that most tears of any size can be repaired this way.
Christopher K. Jones, MD, and Felix H. Savoie III, MD. Arthroscopic Repair of Large and Massive Rotator Cuff Tears. In Arthroscopy. July-August, 2003. Vol. 19. No. 6. Pp. 564-571.
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