These authors compared clinical outcomes of arthroscopic debridement vs. repair for Ellman grade II bursal-side partialthickness rotator cuff tears (i.e. those 3-6 mm deep and not exceeding one half of the tendon thickness).
The rehabilitation program was over twice as long for the patients having repair in contrast to those having debridement:
In patients who underwent arthroscopic debridement, the affected arm was kept in a sling at 15 of abduction and a neutral-rotation brace for 3 weeks. Pendulum and passive ROM exercises were initiated on postoperative day 1. After 3 weeks, patients were encouraged to start self-assisted passive and active ROM exercises. Active strengthening exercises using an elastic band were started at 4-10 weeks postoperatively. Nearly full active ROM was allowed starting at 2.5 months postoperatively.
In patients who underwent RCT repair, the affected arm was kept in an abduction brace for 6 weeks. Pendulum and passive ROM exercises were initiated on postoperative day 1. Self-assisted passive exercises were started at 6-12 weeks postoperatively, and active ROM exercises were conducted starting at 12 weeks postoperatively. Active strengthening exercises using an elastic band were started at 3-6 months postoperatively. Nearly full active ROM was allowed starting at 6 months postoperatively.
All patient-reported outcomes improved in both groups. Outcome scores were better for the debridement group at 6 months postoperatively.
The authors concluded that arthroscopic debridement and repair of Ellman grade II bursal-side partial-thickness rotator cuff tears achieved comparable clinical scores and low retear rates during 2 years of follow-up. Debridement achieved better results, especially within 6 months postoperatively, and achieved a favorable prognosis up to 2 years postoperatively.
Comment: This study demonstrates the value of simple debridement in the management of burial sided cuff tears: (1) the outcomes are reported to be better at 6 months, (2) the cost of suture anchors and increased surgical time is avoided, and (3) the protracted rehabilitation program associated with a cuff repair is avoided.
The technique and value of debridement in the management of cuff tears, including those that are irreparable is shown in this link on the smooth and move procedure.
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