Evaluation of surgical treatment results of massive rotator cuff tear with magnetic resonance imaging

Appropriate treatment selection in the treatment of massive rotator cuff tears is controversial. After the repair of massive tears, re-tears often occur, as well as muscle degeneration and poor clinical outcomes. In this study, we aimed to define the clinical and radiological point reached after long-term follow-up of rotator cuff lesions that we treated with surgical methods and which can be defined as massive tears, and to examine our surgical treatment method using different parameters. We retrospectively evaluated 31 patients with massive rotator cuff tears. Twenty-four of the patients were female and 7 were male. The mean age was 54.7 (36-72). While the dominant side was right in all patients, the patient side was found to be right in 21 patients and left in 10 patients. All patients were evaluated clinically and radiologically. The mean follow-up period was 32.32 months (9-72 months). Re-tear was observed in 12 of 31 patients. While the size of 7 of them remained the same, in 5 of them the tear size was smaller. While the preoperative Constant score was 44.95, it was found to be 88.45 after the operation. Painless flexion was 107.26° preoperatively and 167.42° postoperatively; Abduction was 91.77° before the operation and 160.48° after the operation. Significant improvement was observed in patients' pain and functions according to the visual analog scale (p<0.05). Fatty degeneration was found to be advanced in all patients. There was no statistically significant difference in terms of abduction, flexion, Constant score, pain and function between the group with no postoperative tear and the group with postoperative tear. In conclusion, surgical treatment of a rotator cuff tear is a useful procedure if the symptoms do not respond to conservative treatment and are persistent. In addition to subacromial decompression and acromioplasty, the torn tendon should be tried to be fixed in its anatomical location or close to that area. Thus, it corrects the muscle imbalance in the shoulder area and in parallel, the functional results of the shoulder are improved.