title: Results of arthroscopic decompression and tuberoplasty for irreparable massive rotator cuff tears.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical and radiologic results of arthroscopic tuberoplasty for symptomatic irreparable massive rotator cuff tears.
  
  
  METHODS
  This study enrolled 32 patients (32 shoulders) who underwent arthroscopic tuberoplasty for irreparable massive rotator cuff tears and were followed up for at least 24 months. The mean patient age at the time of surgery was 62.4 years (range, 43 to 76 years), and the mean duration of follow-up was 40 months (range, 24 to 63 months). The Constant score and the University of California, Los Angeles score were used for clinical evaluation. The acromiohumeral interval and inferior scapulohumeral line continuity were used for radiologic evaluation.
  
  
  RESULTS
  Twenty-six shoulders underwent arthroscopic tuberoplasty with concomitant acromioplasty, and 6 shoulders had only arthroscopic tuberoplasty. The Constant score increased from a preoperative mean of 47.6 points to 70.4 points at the last follow-up (P < .001). The University of California, Los Angeles score also improved from a preoperative mean of 15.4 points to 27.1 points at the last follow-up (P < .001), with 3 shoulders (9%) rated as excellent, 23 (72%) as good, and 6 (19%) as poor. The active range of forward flexion improved from 115.9° to 142.7° (P = .024). The final outcomes were not statistically affected by sex, age, preoperative mobility, and existence of a lesion of the long head of the biceps tendon. However, preoperative acromiohumeral interval and inferior scapulohumeral line continuity were statistically correlated with the final results (P < .001 and P = .047, respectively).
  
  
  CONCLUSIONS
  Arthroscopic tuberoplasty with concomitant acromioplasty, as well as treatment of the biceps tendon when indicated, would be an option for diminishing pain and improving active forward elevation for irreparable massive rotator cuff tears. In particular, satisfactory results during the minimum follow-up period of 24 months can be achieved in the cases with good preservation of the preoperative and postoperative acromiohumeral interval and continuity in the inferior scapulohumeral line, regardless of preoperative mobility.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Bong Gun
authors.initials: BG
authors.lastname: Lee
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Cho
authors.forename: Yong Girl
authors.initials: YG
authors.lastname: Rhee
mesh_terms: D000174:Acromion / Q000601:surgery*; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods; D001182:Arthroscopy; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D054850:Osteophyte / Q000601:surgery; D010149:Postoperative Pain / Q000453:epidemiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome