Rockwood et al. report outcomes of open modified Neer acromioplasty, subacromial decompression, and débridement — without tendon repair — in 50 patients (53 shoulders) with massive irreparable rotator cuff tears, followed a mean of 6.5 years. The study asks whether palliative decompression and débridement alone can reliably relieve pain and restore function when repair is not feasible.
When you encounter a patient with a massive, irreparable rotator cuff tear and an intact anterior deltoid and biceps tendon who has failed conservative management, subacromial decompression with débridement is a viable first-line surgical option — but if the anterior deltoid is weak or has been compromised by prior surgery, expect significantly worse outcomes and counsel accordingly.
Rockwood et al. report outcomes of open modified Neer acromioplasty, subacromial decompression, and débridement — without tendon repair — in 50 patients (53 shoulders) with massive irreparable rotator cuff tears, followed a mean of 6.5 years. The study asks whether palliative decompression and débridement alone can reliably relieve pain and restore function when repair is not feasible.
When you encounter a patient with a massive, irreparable rotator cuff tear and an intact anterior deltoid and biceps tendon who has failed conservative management, subacromial decompression with débridement is a viable first-line surgical option — but if the anterior deltoid is weak or has been compromised by prior surgery, expect significantly worse outcomes and counsel accordingly.