Arthroscopic subacromial decompression in the treatment of full-thickness rotator cuff tears

Arthroscopic subacromial decompression has become an accepted treatment for patients with impingement syndrome; however, its use for full-thickness rotator cuff tears is controversial. We observed 25 patients with full-thickness rotator cuff tears treated by arthroscopic subacromial decompression and cuff debridement alone with a minimum of 1 year follow-up observation. Based on the University of California at Los Angeles shoulder rating, 84% of the cases were rated as excellent or good. There was significant improvement in pain, function, motion, and strength. Eighty-eight percent of the patients were satisfied with the procedure. Although all tear sizes improved significantly, smaller tears fared better than larger tears. The preliminary results of arthroscopic subacromial decompression with cuff debridement compare favorably to open techniques of rotator cuff repair with or without acromioplasty and should be considered in selected patients with full-thickness rotator cuff tears.