Fewer rotator cuff tears fifteen years after arthroscopic subacromial decompression.
BACKGROUND
A successful clinical result is reported in 75% to 85% of impingement patients after arthroscopic subacromial decompression. The result is maintained over time, but few studies have investigated the integrity of the rotator cuff in these patients.


METHODS
Using ultrasonography, we examined the integrity of the rotator cuff in 70 patients 15 years after arthroscopic subacromial decompression. All patients had an intact rotator cuff at the index procedure.


RESULTS
Tendons were still intact in 57 patients (82%), 10 (14%) had partial-thickness tears, and 3 (4%) had full-thickness tears.


CONCLUSIONS
The total number of 18% tears (partial and full thickness) in this study, including patients clinically diagnosed with subacromial impingement at a mean age of 60 years, is unexpectedly low compared with 40% degenerative tears reported in asymptomatic adults of the same age.


CONCLUSIONS
Arthroscopic subacromial decompression seems to reduce the prevalence of rotator cuff tears in impingement patients. This appears attributable to elimination of extrinsic factors such as mechanical wear and bursitis. The potential effect of surgery on intrinsic cuff degeneration is unknown, but intrinsic factors may explain tears still developing despite decompression.


METHODS
Level III, therapeutic study.
Björnsson
Hanna
H
Department of Orthopaedics, University Hospital, Linköping, Sweden. hanna.bjornsson@lio.se
Norlin
Rolf
R
Knutsson
Anders
A
Adolfsson
Lars
L
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D017678:Sex Distribution; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D013708:Tendon Injuries / Q000453:epidemiology* / Q000517:prevention & control; D014463:Ultrasonography