Objective: Regain of shoulder function and freedom of pain through arthroscopic fixation of the torn rotator cuff using anchors and tension bands.
Indications: Isolated full-substance rupture of the supraspinatus. Full-substance tear of the supraspinatus and the superior part of the infraspinatus. Incomplete tears affecting the superior part of the subscapularis, either isolated or associated with rupture of the supraspinatus. For lesions of the long head of the biceps: tenodesis in patients < 60 years of age or in blue-collar workers; tenotomy in all other instances.
Contraindications: Fatty infiltration of infraspinatus and subscapularis of stage 3 and 4. Frozen shoulder in the active phase. Narrowing of the subacromial space (< 7 mm). Complete tear of the subscapularis. Complete tear of the posterosuperior cuff reaching the teres minor. Patients >or=65 years.
Surgical technique: Subacromial bursoscopy and glenohumeral arthroscopy. Repair of supraspinatus using a posterior portal and an inside-out anterior portal, associated with one or two additional anterolateral portals. Attachment with a single row of anchors. Tenotomy/tenodesis of long head of biceps, if indicated.
Results: 50 patients, follow-up of an average of 24 months. 34 watertight repairs, Constant Score 85.2; complete tear or leakage in 16 patients, Constant Score 77.4 points.