title: Results of arthroscopic partial repair of large retracted rotator cuff tears.
abstract: OBJECTIVE
  To evaluate the midterm results of partial rotator cuff repair using the Constant score and the acromiohumeral radiographic measurement.
  
  
  METHODS
  Thirty-eight patients with a mean age of 65 years and a large retracted rotator cuff tear (at least 2 tendons) were included in the study. Patients underwent clinical examination, standard radiography, and isometric strength testing at a mean follow-up of 47 months. The rotator cuff tears were classified as posterosuperior, anterosuperior, or global tears (≥3 tendons), and an arthroscopic partial repair was performed.
  
  
  RESULTS
  The mean Constant score significantly increased from 56 points before surgery to 71 points after surgery (P = .041); the mean age- and sex-adjusted Constant score significantly improved from 63% to 90% at a mean follow-up of 47 months after arthroscopic partial rotator cuff repair (P = .003); and the subcategories pain and activity significantly improved (P = .001, P = .014, respectively). The active range of motion improved from 133° of flexion and 111° of abduction before surgery to 163° of forward flexion and 156° of abduction after surgery (P < .001). However, the active range of external rotation decreased from 44° before surgery to 36° after surgery. Further, there was a trend toward a decrease in the mean acromiohumeral distance from 7.0 mm before surgery to 5.6 mm after surgery. The abduction strength did not significantly improve after surgery (4.2 kg before surgery and 4.8 kg after surgery; P = .116).
  
  
  CONCLUSIONS
  An arthroscopic partial repair of the rotator cuff is an effective tool to improve the Constant score by restoring active forward flexion and abduction and through pain relief. Further, we found that a pathologically decreased acromiohumeral distance cannot be reversed by a partial rotator cuff repair.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopedic Surgery, Hannover Medical School, Hanover, Germany. wellmann.mathias@web.de
authors.forename: Mathias
authors.initials: M
authors.lastname: Wellmann
authors.forename: Sven
authors.initials: S
authors.lastname: Lichtenberg
authors.forename: Gaspar
authors.initials: G
authors.lastname: da Silva
authors.forename: Petra
authors.initials: P
authors.lastname: Magosch
authors.forename: Peter
authors.initials: P
authors.lastname: Habermeyer
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D022125:Lacerations / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome