The Results of Subacromial Decompression in Patients with and without Rotator Cuff Tears

Background The decision to repair the rotator cuff in patients with impingement is controversial. This study aimed to determine whether there was a difference in outcome in patients both with and without rotator cuff tears undergoing subacromial decompression (SAD). Methods Ninety-eight patients underwent an arthroscopic SAD for impingement. No rotator cuff tear was repaired. The patients were assessed pre-operatively, at 6 months and 3 years using the ASES, Constant, DASH and the physical SF-36 scores. The rotator cuff was categorized as ‘tear/no tear’ depending on whether a cuff tear was present. Results Both the ‘tear’ and ‘no tear’ groups showed a significant improvement with all scores at 6 months and 3 years. There was no significant difference in these outcome measures between the ‘tear’ and ‘no tear’ groups at 6 months. At 3 years there was no significant difference between the groups using the ASES and DASH scores, but there was a significant improvement in the Constant and SF-36 scores in the ‘no tear’ group. Conclusion SAD significantly improves outcome even in patients whose cuff tear was left unrepaired. Comparison of the ‘tear’ and ‘non-tear’ patient groups suggest that cuff tears can be left unrepaired in selected patients.