Arthroscopic repair of large and massive rotator cuff tears

The purpose of this study was to evaluate the outcome of arthroscopically repaired large and massive rotator cuff tears at 1- to 5-year follow-up.

Retrospective chart review.

Sixty consecutive patients who had arthroscopically repairable large or massive tears were identified by retrospective chart review. Large tears are defined as defects in the cuff measuring from 3 to 5 cm and massive tears measuring greater than 5 cm. Ten of these patients were lost to follow-up before 1 year postoperatively and were excluded from the study. The remaining 50 were the focus of this study.

Thirty-seven patients had large tears and 13 had massive tears. Follow-up averaged 32 months (range, 12 to 63 months). Based on the University of California Los Angeles shoulder rating, 88% of patients had good or excellent outcomes. Although 6 patients were considered failures based on the UCLA score, 98% of patients were satisfied with the result. Only 1 of these failures underwent a second operation for revision repair. There was no significant difference in final scores when comparing the massive tears to the entire group, but all preoperative scores were lower for those with massive tears than the large tears.

Arthroscopic management of large and massive tears results in good or excellent outcomes in 88% of patients, which is comparable to reported outcomes following open repairs.