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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2008 October;59(5):275-81
The opened reconstruction in the inveterate massive tears of the rotator cuff. Our experience
Zanchi A., Minati S., Boi M., Bianchini G.
Reparto di Ortopedia Ospedale Civile di Cles, Trento, Italia
Aim. The aim of this study was to illustrate the experience of the authors concerning 12 years of treatment of the inveterate massive tears of the rotator cuff with open surgery. Results are appraised through distance, clinically and, in some cases, instrumental examinations.
Methods. Eighty-nine patients operated in a period of 12 years at the Civil Hospital of Cles have been re-evaluated with a follow-up of 5.8 years. In 27 cases the cuff was inserted into the great tubercle. In 31 cases the subspinatus was inserted again and the suture side-to-side of the sovraspinatus was effected with the interval of the rotators. In three cases the procedure was performed according to Apoil and Augereau; in 16 cases the head homeral was covered with soft tissue of proximity; in 12 cases only the simple acromionplasty was performed for the absolute absence of soft subacromiali structures.
Results. Results were satisfactory. A good improvement of all the considered parameters in comparison to the preoperative evaluation was detected. The cases re-evaluated with nuclear magnetic resonance and radiography did not show any atrophy evolution.
Conclusion. In our opinion open surgery represents a valid option to treat the inveterate lesions of the rotator cuff in elderly patients and when the possibility of reparation is in doubt.