ARTHROSCOPIC MANAGEMENT OF ROTATOR CUFF DISEASE

The etiology of rotator cuff disease is controversial, but is not alwa ys secondary to cuff impingement between the humeral head and the cora coacromial arch. Rotator cuff disease, and not impingement syndrome, m ore accurately describes this process. The spectrum of rotator cuff di sease begins with rotator cuff inflammation (Stage I) and progresses t o tendinitis (Stage II) and partial or full thickness tears (Stage III ). Refractory Stage II and III disease without rotator cuff tears unde rgoes subacromial bursectomy and acromioplasty. Partial thickness tear s are debrided with an acromioplasty, bursectomy, and removal of infer ior clavicular osteophytes. Full thickness tears are treated arthrosco pically or open, depending on the tear size and the patient expectatio ns. In general, tears from 0 to 5 cm in active patients undergo subacr omial decompression and a mini-open repair. Low demand patients with 0 to 5 cm tears or tears greater than 5 cm are treated with subacromial decompression and rotator cuff debridement.