ARTHROSCOPIC SUBACROMIAL DECOMPRESSION IN THE TREATMENT OF FULL-THICKNESS ROTATOR CUFF TEARS - A 3-YEAR TO 6-YEAR FOLLOW-UP

Arthroscopic subacromial decompression has become an accepted treatmen t for patients with impingement syndrome; however, its use for full th ickness rotator cuff tears continues to be controversial. The purpose of this study is to determine if the results of arthroscopic subacromi al decompression alone for full thickness rotator cuff tears deteriora te at long-term follow-up. We reevaluated all 25 patients with full th ickness rotator cuff tears who underwent arthroscopic subacromial deco mpression from our original study group. Based on the University of Ca lifornia at Los Angeles shoulder rating, 68% of patients were rated as excellent or good at the present mean follow-up of 45.8 months (range 36-72 months). This represents a significant decrease from our initia l report of 84% satisfactory results at a mean follow-up of 24.6 month s. There was a significant decrease in ratings with regard to pain and function; however, no significant deterioration was noted with regard to motion and strength. Two additional patients required open rotator cuff repair since the time of initial follow-up for a total of six. L arge and massive rotator cuff tears fared worse over time as compared with small and moderate size tears. Although 1- to 3-year results of a rthroscopic subacromial decompression and rotator cuff debridement wer e favorable, the long-term follow-up demonstrates deterioration or res ults. We therefore cannot support the use of decompression and debride ment alone in the treatment of repairable full thickness rotator cuff tears.