Surgical Management of Full Thickness Rotator Cuff Tears

Forty-five patients who had surgery to repair a full thickness rotator cuff tear (45 shoulders) were followed for an average of 35.5 months (range, 6 to 72). Thirty were men and 15 women. The average age of the patients was 56 years (range, 31 to 67 years). After anterior acromioplasty, tendon to bone repair was accomplished in 37 shoulders, tendon to tendon repair in three, and repair with Teflon felt in five. It was necessary to transfer the subscapularis in three shoulders and to advance supraspinatus in one shoulder. Generally patients were placed in abduction braces to hold the shoulder in 60° to 90° flexion and abduction after the operation. Patients received passive ROM (range of motion) exercises to the shoulder for the initial 4 to 6 weeks. This therapy was followed by active assisted ROM and finally by active ROM as strength was regained. Using JOA score, excellent or good results were achieved in 93% of the patients with small or medium tears (5cm≥, N=29). However, excellent or good results were achieved in 70% of large or massive tears (5cm