Massive, Irreparable Tears of the Rotator Cuff. Results of Operative Débridement and Subacromial Decompression*

Thirty-three consecutive patients in whom an irreparable tear of the rotator cuff had been treated with operative débridement and subacromial decompression were evaluated both preoperatively and postoperatively with regard to pain, ability to perform activities of daily living, range of motion, strength, and satisfaction. The assessments were performed with the Shoulder Score Index of the American Shoulder and Elbow Surgeons and the scoring systems of the University of California at Los Angeles and Constant and Murley. At the time of follow-up, twenty-six patients thought that the condition of the shoulder was improved; three, that it was unchanged; and four, that it was worse after the operation. There was a significant decrease in pain (p = 0.001) and significant increases in the range of motion (p = 0.038) and the ability to perform activities of daily living (p = 0.016). However, these improvements were inferior to those in reported series in which torn rotator cuffs had been repaired. Strength with elevation was decreased after the operations in the present series (p = 0.0007).