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Three Surgical Methods Compared for Rotator Cuff Tears

In this study, one orthopedic surgeon from the University of Florida compared the results of three different operations for the same problem. Each patient had a massive tear of the rotator cuff.

The rotator cuff is a group of four muscles that surround the shoulder. They work together to hold the ball-shaped top of the humerus (upper arm bone) in the shoulder socket. Each muscle of the rotator cuff helps the shoulder move in a different way. A massive tear was defined as two or more tendons with a tear that measured 5 cm or more.

The three surgical procedures used included partial repair, complete repair, and debridement. Debridement is simply removing the frayed edges of a tear and smoothing everything around it.

Each patient was given the same postoperative rehab program. Everyone was followed for at least two years. Results were measured by range of motion and strength.

Overall, the repair patients had the best results. The shoulders were better balanced after surgery. They had better motion and strength. The debridement group had the worst results. The patients got very little pain relief or improvement in function.

This study may be the first one to directly compare all three operations. Most studies look at the results of one type of repair or one type of rotator cuff tear. The authors agree that rotator cuff repairs can be difficult and complex. It's not always possible to tell who will get good results. They suggest any repair (partial or complete) is better than debridement alone.

References: Michael Moser, MD, et al. Functional Outcome of Surgically Treated Massive Rotator Cuff Tears: A Comparison of Complete Repair, Partial Repair, and Debridement. In Orthopedics. June 2007. Vol. 30. No. 6. Pp. 479-482.

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