Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: technique and preliminary results.

PURPOSE: The purpose of this study is to describe the technique and review the preliminary results of arthroscopic repair of massive, contracted, immobile rotator cuff tears using an interval slide technique.

TYPE OF STUDY: Case series.

METHODS: From January 1999 to December 2000, the senior author (S.S.B.) performed arthroscopic rotator cuff repair on 94 massive rotator cuff tears. Of these, 9 (9.6%) were massive, severely contracted rotator cuff tears and required repair using an interval slide technique. A single interval slide was used in 6 patients, and a double interval slide was used in 3 patients. All patients were evaluated preoperatively and postoperatively using a modified University of California Los Angeles (UCLA) scoring system.

RESULTS: At a mean follow-up time of 17.9 months (range, 10-24 months), 8 of 9 patients were satisfied with the procedure. The mean UCLA score increased from 10.0 preoperatively to 28.3 postoperatively (P <.00001). All patients showed some improvement in active motion, strength, or function. Active forward flexion improved significantly, from a preoperative mean of 108 degrees to a postoperative mean of 146.1 degrees (P =.025). Active external rotation increased significantly from a preoperative mean of 24.4 degrees to a postoperative mean of 35.0 degrees (P =.04). A significant increase in strength grade (2.2 to 3.6; P <.005) and function (2.5 to 7.1; P <.0005) were also seen. We encountered no significant complications to the procedure.

CONCLUSIONS: The interval slide technique provides a method of mobilization of massive, severely contracted, immobile rotator cuff tears allowing repair of previously irreparable tears. This technique, in conjunction with arthroscopic rotator cuff repair, may provide patients with improvements in pain, motion, strength, and overall shoulder function.

LEVEL OF EVIDENCE: Level IV.