Irreparable rotator cuff tear after failed rotator cuff repair

 A 60 year old man had a rotator cuff repair six years prior to presentation to us. Shortly after his repair he felt his repair had failed. He came in seeking treatment for progressive loss of comfort and function.

His physical examination revealed full passive range of motion and painful active elevation to 90 degrees with palpable and audible crepitus on motion.

His images showed no glenohumeral arthritis

and a supraspinatus tendon retracted to the level of the glenoid

After discussion of the alternatives, he elected to proceed with a smooth and move procedure.

At surgery his supraspinatus was irreparable, his subscapularis and biceps were intact. His infraspinatus was intact except for the upper 1/5th of the tendon. His coracoacromial arch was intact. There was no evidence of cuff tear arthropathy.  Substantial loose sutures were removed from his subacromial space. The bursa was excised and a tuberoplasty was performed. His CA arch was preserved.

Two hours after his procedure he had full comfortable active elevation of his shoulder without crepitant and was discharged home with a plan of immediate return to unrestricted activities.

To see our technique for the smooth and move procedure, click on this link. 

Comment: The smooth and move is a quick, safe and cost effective method for managing irreparable cuff tears with retained active elevation.

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