DEBRIDEMENT OF DEGENERATIVE, IRREPARABLE LESIONS OF THE ROTATOR CUFF

A modified Neer acromioplasty, subacromial decompression, and debridem ent of massive, irreparable lesions of the supraspinatus and infraspin atus tendons was performed in fifty-seven patients, Fifty patients (fi fty-three shoulders) were followed for an average of six and one-half years. The average age of the patients was sixty years (range, thirty- eight to seventy-four years). The results, as rated on the basis of pa in, function, range of motion, strength, and satisfaction of the patie nt, were satisfactory in forty-four shoulders (83 per cent) and unsati sfactory in nine (17 per cent), A favorable outcome was observed in sh oulders in which both the anterior portion of the deltoid muscle and t he long head of the biceps tendon were intact and in which no previous acromioplasties or operations on the rotator cuff had been performed, An unsatisfactory outcome was observed in shoulders in which the ante rior part of the deltoid muscle was weak or absent or in which a previ ous acromioplasty and attempted repair of the rotator cuff had been pe rformed, The active forward flexion of the shoulder improved from an a verage of 105 degrees preoperatively to an average of 140 degrees post operatively. The results of the present study suggest that, with prope r rehabilitation, adequate decompression of the subacromial space, ant erior acromioplasty, and debridement of massive tears of the rotator c uff can lead to the relief of pain and the restoration of shoulder fun ction.