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The Journal of Bone and Joint Surgery 79:776-83 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Combined Arthroscopic and Open Treatment of Tears of the Rotator Cuff*{dagger}

GARY M. GARTSMAN, M.D.{ddagger}, HOUSTON, TEXAS

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons


   Introduction
 
In the last decade, arthroscopy of the shoulder has advanced from a diagnostic tool to an effective treatment option for stage-II impingement (fibrosis and thickening of the tendon), partial-thickness tears of the rotator cuff, and arthrosis of the acromioclavicular joint1,3-5,8,11,14. Full-thickness tears of the rotator cuff have been treated with arthroscopic decompression without repair of the tendon2-4. However, this procedure does not reliably produce good results, and it is clear that most full-thickness tears necessitate repair.

At present, the technique for decompression of the shoulder and repair of the tendon varies. Some surgeons prefer open repair while others use arthroscopic techniques exclusively. A third option combines arthroscopic and open operative methods. This Instructional Course Lecture will present the rationale and technique of combined arthroscopic and open treatment of partial-thickness and complete tears of the rotator cuff. The treatment of stage-II impingement and massive, irreparable tears will not be . . . [Full Text of this Article]


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