Arthroscopic Subacromial Decompression for Small and Medium Size Tears of Rotator Cuff without Tendon Repair

According to our previous clinical impression, we hypothesized that patients who had symptomatic rotator cuff tendon tear in a diamemter below 3 cm would benefit from arthroscopic subacromial decompression only, without the need for the repair of the thorn tendon. From 1998 to 2003, 160 patients (168 shoulders) had arthroscopic subacromial decompression for impingement syndrome with a torn rotator cuff without repairing the tear of the cuffs (120 males and 40 females). The average patient age was 64 years and the average follow up was 30 months. At follow up, 96 patients (60%) had full recovery; 55 patients (35%) had residual low grade shoulder pain on effort and 7 patients (5%) had poor outcome. In the last group of patients with unsatisfactory outcome, the postoperative Constant score was only 64 points. In 95% of patients, the average Constant score values raised from average preoperative value of 62 to postoperative average score of 82. According to these results, there is an indication that in patients in the seventh decade of life or older with symptomatic rotator cuff tear, pain relief and good shoulder function can be achieved by more conservative approach of subacromial decompression alone, providing a clear diagnosis that the diameter of the tear in the supraspinatus and infraspinatus tendons is below 3 cm.