Arthroscopic repair of combined anterior and superior cuff tear

Abstract

Purpose The aim of this study is to evaluate the results of arthroscopic repair of combined anterior and superior cuff tear. Patients and methods One-stage arthroscopic repair of concomitant supraspinatus and subscapularis tendon tear was performed in 25 patients. All patients were evaluated at a minimum 1-year follow-up with a visual analog scale score for pain; subjective shoulder value, which was used for subjective evaluation of the affected shoulder as a percentage of the normal one; range of motion; the American Shoulder and Elbow Surgeons score; and University of California at Los Angeles scores for clinical assessment. Belly-Press test and lift-off test, in particular back-to-hand distance, were used to evaluate subscapularis function. Empty can test was used to evaluate the supraspinatus strength. Results The mean age at the time of surgery was 53.9±11.3 years. The rate of dominant arm involvement was 60% of the patients. At the final follow-up, the mean visual analog scale score improved significantly to 0.38±0.01 points postoperatively (P<0.01). The mean subjective shoulder value improved from 36.5±6.98 preoperatively to 89.9±7.52 at the end of follow-up, and this was significant (P<0.001).The mean American Shoulder and Elbow Surgeons score improved significantly to 90.8±8.45 at the mean 1-year follow-up (P<0.001). The mean University of California at Los Angeles score improved significantly to 30.4±3.85 at the end of follow-up (P<0.001). Patients gained a significant reduction of belly-press angle from 36.5±12.5 to 13.9±3.25 (P<0.0026). Back-to-hand distance significantly improved from 2.95±0.68 to 6.0±1.33\u2009cm (P<0.0033). The mean active forward flexion and the mean active internal rotation significantly improved postoperatively, whereas the mean active external rotation was nonsignificantly reduced. Of the 25 shoulders, 23 (92%) were considered by the patients to be much better or better as a result of the operation. Conclusion The arthroscopic tackling of concomitant shoulder anterior and superior rotator cuff tears showed satisfactory results and fastened the return to normal activity at 1-year follow-up, as well as postoperative stiffness was avoided. Level of evidence: Level III, case–control study.