Experience in Arthroscopic Treatment of Massive Rotator Cuff Injuries in Elderly Patients

Abstract

Arthroscopic treatment results for 6 elderly patients (mean age 64 years) with massive (over 5 cm) nonreconstructable rotator cuff tear are presented. In all cases fatty degeneration of the rotator cuff tendon above 3 rd degree by Goutallier classification was present. In all patients elbow arthroscopy with implantation of InSpace Balloon into subacromial space was performed. Mean score by UCLA scale made up 14 (12-15) preoperatively and over 30 in 6 months after intervention that corresponded to a good and excellent result. Preliminary results indicate that applied technique is a simple, mini-invasive and effective intervention enabling to reduce pain and increase range of movements in this group of patients.

Keywords

rotator cuff / massive nonreconstructable tear / arthroscopy / elbow joint / InSpace balloon

References

[1] Cole B.J., ElAttrache N.S., Anbari A. Arthroscopic rotator cuff repairs: An anatomic and biomechanical rationale for different suture-anchor repair configurations. Arthroscopy. 2007; 23: 662-9.

[2] Cuff D., Pupello D., Virani N., Levy J., Frankle M. Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency. J. Bone Joint Surg. Am. 2008; 90: 1244-51.

[3] Goutallier D., Postel J.M., Bemageau J., Lavau L., Voisin M.C. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin. Orthop. Relat. Res. 2007; (304): 78-83.

[4] MacDonald P.B., Altamimi S. Principles of arthroscopic repair of large and massive rotator cuff tears. Instr. Course Lect. 2010; 59: 269-80.

[5] Moser M., Jablonski M.V., Horodyski M., Wright T.W. Func- tional outcome of surgically treated massive rotator cuff tears: A comparison of complete repair, partial repair, and debride- ment. Orthopedics. 2007; 30: 479-82.

[6] Senkovic V., Poberaj B., Kovacic L., Mikek M., Adar E., Dekel A. Prospetive clinical study of a novel biodegradable subacromial spacer in treatment of massive irreparable rotator cuff tears. Eur. J. Orthop. Surg. Traumatol. 2013; 23 (3): 311-6.

[7] http://orthospace.co.il/professional/how-does-it-work.

[8] Londo U.G., Franceschetti E., Petrillo S., Maffulli N., Denaro V. Latissimus dorsi tendon transfer for massive irreparable rotator cuff tears: A systematic review. Sports Med. Arthrosc. 2011; 19: 428-37.

[9] Lee B.G., Cho N.S., Rhee Y.G. Results of arthroscopic decom- pression and tuberoplasty for irreparable massive rotator cuff tears. Arthroscopy. 2011; 27: 1341-50.

[10] Mulieri P., Dunning P., Klein S., Pupello D., Frankle M. Reverse shoulder arthroplasty for the treatment of irreparable rotator cuff tear without glenohumeral arthritis. J. Bone Joint Surg. Am. 2010; 92: 2544-56.

[11] Sartoretti C., Sartoretti-Schefer S., Duff C., Buchmann P. Angioplasty balloon catheters used for distraction of the ankle joint. Arthroscopy. 1996; 12: 82-6.

[12] Kilinc A.S., Ebrahimzadeh M.H., Lafosse L. Subacromial internal spacer for rotator cuff tendon repair: “The balloon technique.” Arthroscopy. 2009; 25: 921-4.

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