Treatment of Massive Irreparable Rotator Cuff Tear with Arthroscopic Subacromial Bursectomy, Biceps Tenotomy, and Tuberoplasty

Background: The alternative surgery for massive and irreparable shoulder rotator cuff tears in older patients is thedebridement of subacromial bursa, biceps tenotomy, and tuberoplasty (reverse acromioplasty). This study aimed toreport the effectiveness of such a treatment performed arthroscopically in a small group of patients for a short periodof time.Methods: This prospective study was conducted on 12 patients with massive irreparable rotator cuff tear during 2014-2017. Participants with the mean age of 65 were subjected to arthroscopic debridement of subacromial bursa, necroticrotator cuff tendon remnants, and tuberoplasty without coracoacromial ligament excision. The sign and symptoms ofpatients before and after the surgery were evaluated based on Modified-University of California at Los Angeles (UCLA)Shoulder Score.Results: With the mean follow-up of 18 months (12-24 months), the mean of the modified UCLA score improved from9.2 to 27.5. The obtained results of the study revealed that the pain and range of motion improved to near normal in theparticipants. The functional outcome was good although there were a decrease of acromiohumeral distance from 5 to4 mm and a slight increase in degenerative changes.Conclusion: This simple arthroscopic procedure is recommended for massive irreparable rotator cuff tear, especiallyin elderly patients.Level of evidence: IV