Complete repair of massive rotator cuff tear

Bancha Chernchujit, M.D.
Katreese Kimberly Samsuya, M.D.
Thammasat University

AOSMAK volume 2 (2022)

Archives of Orthopedic Sports Medicine and Arthroscopy Knowledge (AOSMAK) is an open-access peer-reviewed journal of Thai Orthopaedic Society for Sports Medicine (TOSSM)

Complete repair of massive rotator cuff tear
The prevalence of massive rotator cuff tears is 40% of all rotator cuff tears with repair failure rate of as much as 79%. Various management options, both non-surgical and surgical, are available but the selection of the most appropriate treatment can be challenging and is still controversial. As much as possible, we always try to repair the tear and because of the improved techniques and technology in the recent times, outcome of complete repair of a massive cuff tear has improved. In this paper, we present a case of 66 years old, male who presented with four months history of severe left shoulder pain that interferes with activities of daily living. He had full range of motion but special tests indicated supraspinatus and subscapularis tears. MRI confirmed complete tear of both supraspinatus and infraspinatus with tendon retraction to the level of the glenoid and fatty infiltration. We successfully repaired this arthroscopically using a double-row trans-osseus equivalent technique (TOE) utilizing triple release of the subscapularis muscle to mobilize the tendons and achieve a tension-free repair. Post-op MRI showed good tendon healing and improvement of fatty degeneration. At 20-months follow-up, patient is pain-free with full ROM.