ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1615015
Arthroscopic partial repair versus debridement combined with acromioplasty alone for irreparable rotator cuff tears in the elderly
Provisionally accepted
- Shandong Wendeng Osteopathic Hospital, Shandong, China
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Objective: To compare postoperative outcomes of arthroscopic partial repair versus debridement combined with acromioplasty in elderly patients with irreparable rotator cuff tears, focusing on pain relief, functional improvement, and quality-of-life enhancement. Methods: Between January 2019 and March 2022, 41 patients (partial repair group, n=21; debridement group, n=20) with irreparable rotator cuff tears were prospectively enrolled. Functional outcomes (Constant-Murley Score [CMS], University of California Los Angeles Score [UCLA]) were assessed preoperatively and 12 months postoperatively. Visual Analog Scale (VAS) scores were recorded at 2 and 6 weeks. Magnetic resonance imaging (MRI) and anteroposterior X-rays were used to measure global fatty degeneration index (GFDI) and acromiohumeral distance (AHD). Tendon healing was evaluated using the Sugaya classification system. Results: All surgeries were completed without complications. Follow-up averaged 14.1 months (range, 12–18 months). Postoperative CMS (partial repair: 43.57–70.86 vs. debridement: 42.55–58.95) and UCLA scores (partial repair: 8.67–21.43 vs. debridement: 8.30–18.40) improved significantly in both groups (P<0.05), with greater enhancements in muscle strength and range of motion favoring partial repair. VAS scores were higher in the partial repair group at 2 weeks (3.1±0.8 vs. 2.1±0.7, P<0.05) but equivalent at 6 weeks (P>0.05). Postoperative GFDI increased in both groups (P<0.05) without intergroup differences. AHD remained stable in the partial repair group (P>0.05) but decreased in the debridement group (P<0.05), with higher AHD persisting in the partial repair subgroup (P<0.05). Subgroup analysis revealed no differences in outcomes between re-tear and non-re-tear patients. Preoperative AHD correlated positively with postoperative CMS and UCLA scores (P<0.05), while Sugaya classification and preoperative GFDI showed no association with functional outcomes. Conclusion: Arthroscopic partial repair yielded superior functional outcomes compared to debridement combined with acromioplasty in elderly patients with irreparable rotator cuff tears, particularly enhancing shoulder strength and range of motion while preserving AHD. Early postoperative pain should be anticipated. Preoperative AHD emerged as a predictor of functional recovery.
Keywords: Irreparable rotator cuff tear, Arthroscopy, Partial repair, Debridement, Elderly
Received: 20 Apr 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 LI, Sun, Zhang, Kang, Jiang and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liwu Qin, Shandong Wendeng Osteopathic Hospital, Shandong, China
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