title: Tuberoplasty: creation of an acromiohumeral articulation-a treatment option for massive, irreparable rotator cuff tears.
abstract: This article reports the results of treatment for irreparable tears of the rotator cuff with a new procedure that we have termed a tuberoplasty. The tuberoplasty procedure involves removal of exostoses on the humerus followed by reshaping of the greater tuberosity to create a smooth, congruent acromiohumeral articulation. The coracoacromial ligament is preserved, and an acromioplasty is not performed. Twenty patients underwent this procedure with a minimum 27-month follow-up. All patients had significant disabling pain and weakness preoperatively. On the basis of the modified UCLA rating scale, the overall score increased from 9.3 to 27.7, with 12 excellent results, 6 good results, and 1 fair result (95% satisfactory). Pain relief was most dramatic, with 13 patients (68%) completely pain-free. All patients were able to perform activities of daily living, and 9 of 11 who were employed preoperatively returned to work. All patients had residual weakness in external rotation. There were no poor results and no complications.
authors: Jefferson Shoulder Center, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pa, USA.
authors: John M
authors: JM
authors: Fenlin
authors: Jeffrey M
authors: JM
authors: Chase
authors: Scott A
authors: SA
authors: Rushton
authors: Barbara G
authors: BG
authors: Frieman
mesh_terms: D000174:Acromion / Q000601:surgery*; D000203:Activities of Daily Living; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D013997:Time Factors