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Department of Orthopedics, Hannover Medical School, Giessen, Germany.
We reexamined 97 of 116 shoulders operated on for rotator cuff lesions after an average follow-up time of 37 months. Seventy percent had a good or excellent clinical result, and 14 percent were graded as poor. Upon ultrasonographic examination of the 97 shoulders, 37 had a normal rotator cuff, 31 had thinning and/or hyperdensity, and 29 had a complete rupture of the cuff. Patients with concomitant anterior acromioplasties did better than those without. There was a poor correlation between clinical and ultrasonographic results. We recommend that rotator cuff tears should be closed only if this can be achieved without undue tension. If extensive tissue mobilization or coverage with alloplastic material or with regional muscle flaps is required, the lesion should be debrided and left open, and only an anterior acromioplasty should be performed.
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