BACKGROUND: Massive irreparable rotator cuff tears are becoming increasingly difficult to manage. METHODS: Patients were considered for treatment if they had a painful shoulder in the presence of a compensated cuff tear. All patients had radiological evidence of a massive irreparable cuff tear and underwent suprascapular neurotomy, arthroscopically. RESULTS: There were 15 males and 25 females with a mean age of 74 years (range 59 years to 88 years). The mean pre-operative Oxford Shoulder Score (OSS) in all patients was 17.7, with a mean pre-operative visual analogue score (VAS) of 8.0. The mean post-operative OSS was 30.8 [27.42-34.18 = confidence interval (CI) 95%] with a mean VAS of 3.6 (2.64-4.56 CI 95%) at the 3-month (short-term) period (n = 32). The medium-term (1-year) OSS and VAS had improved to 33.6 (32.27-34.93 = CI 95%) and 3.7 (0-8.39 CI 95%) respectively (n = 26). The difference pre- and postoperatively at 12 months was statistically significant (p < 0.001). Patients who underwent biceps tenotomy at the time of surgery had a less significant improvement in their VAS and OSS. CONCLUSIONS: Suprascapular neurotomy can afford medium-term benefit in over two-thirds of the patients who would otherwise have undergone reverse polarity shoulder replacements. We consider that this is a reproducible technique.
BACKGROUND: Massive irreparable rotator cuff tears are becoming increasingly difficult to manage. METHODS:Patients were considered for treatment if they had a painful shoulder in the presence of a compensated cuff tear. All patients had radiological evidence of a massive irreparable cuff tear and underwent suprascapular neurotomy, arthroscopically. RESULTS: There were 15 males and 25 females with a mean age of 74 years (range 59 years to 88 years). The mean pre-operative Oxford Shoulder Score (OSS) in all patients was 17.7, with a mean pre-operative visual analogue score (VAS) of 8.0. The mean post-operative OSS was 30.8 [27.42-34.18 = confidence interval (CI) 95%] with a mean VAS of 3.6 (2.64-4.56 CI 95%) at the 3-month (short-term) period (n = 32). The medium-term (1-year) OSS and VAS had improved to 33.6 (32.27-34.93 = CI 95%) and 3.7 (0-8.39 CI 95%) respectively (n = 26). The difference pre- and postoperatively at 12 months was statistically significant (p < 0.001). Patients who underwent biceps tenotomy at the time of surgery had a less significant improvement in their VAS and OSS. CONCLUSIONS: Suprascapular neurotomy can afford medium-term benefit in over two-thirds of the patients who would otherwise have undergone reverse polarity shoulder replacements. We consider that this is a reproducible technique.
Authors: Chris Hyunchul Jo; Ji Sun Shin; Young Gil Lee; Won Hyoung Shin; Hyang Kim; Seung Yeon Lee; Kang Sup Yoon; Sue Shin Journal: Am J Sports Med Date: 2013-08-06 Impact factor: 6.202
Authors: Timothy P C Kane; Peter Rogers; Jane Hazelgrove; Simon Wimsey; Gareth D Harper Journal: J Shoulder Elbow Surg Date: 2008-03-07 Impact factor: 3.019