title: Surgical management of irreparable rotator cuff tears.
abstract: OBJECTIVE
  In this prospective case control study, the effectiveness of surgical management of irreparable rotator cuff tears in terms of patient's status and quality of life was evaluated in two groups of patients: one group receiving arthroscopic debridement associated with acromioplasty and bursectomy and the other receiving an arthroscopic partial repair of the rotator cuff tear.
  
  
  METHODS
  Sixty-eight patients (47 males and 21 females) undergoing arthroscopic shoulder surgery for massive irreparable rotator cuff tear were enrolled in our study. Patients were divided into two groups: Group AP (debridement associated with acromioplasty and bursectomy) and Group PR (partial repair). Pre- and post-operative range of motion (ROM), modified-UCLA shoulder score and strength measurement were performed. The RC-QOL was used at the time of the last follow-up to assess patients' perception of their quality of life.
  
  
  RESULTS
  The final follow-up was 7.8 (±2.3, range 5-9) years. ROM measures were significantly increased from pre- to post-operative evaluations, with significant intergroup differences (P < 0.001). The overall modified-UCLA shoulder score showed a mean pre-operative value of 7.6 ± 2.6 (95 % CI 6.7-8.5) for Group AP and 8.6 ± 4.1 (95 % CI 7.0-9.9) (n.s.) for Group PR. The post-operative values at the latest follow-up showed a statistically significant improvement in both groups [21.4 ± 3.7 (95 % CI 20.1-22.7) for Group AP and 28.8 ± 4.2 (95 % CI 27.3-30.2) for Group PR] (P < 0.0001), with a significant intergroup difference (P < 0.0001). The RC-QOL demonstrated a statistically significant difference between the groups [Group AP: 61.8 ± 6.1(95 % CI 59.6-63.9); Group PR: 71.2 ± 9.8 (95 % CI 67.7-74.6)] (P < 0.0002).
  
  
  CONCLUSIONS
  Both techniques are effective in reducing patients' symptoms, with higher functional outcomes for partial repair. However, the choice of which technique to undertake should take into account the patients' features concerning the acromio-humeral interval and levels of daily activities.
  
  
  METHODS
  Therapeutic case-control study, Level III.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy, f.franceschi@unicampus.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Vasta
authors.forename: Francesco
authors.initials: F
authors.lastname: Leonardi
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000174:Acromion / Q000601:surgery*; D000368:Aged; D001182:Arthroscopy; D002061:Bursa, Synovial / Q000601:surgery*; D016022:Case-Control Studies; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D064232:Visual Analog Scale