Review Question - QID 6577

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Subacromial Impingement QID: 6577 (SAE08UE.15)

QID 6577 (Type "6577" in App Search)

A 39-year-old man has had persistent right shoulder pain for the past 6 months. A formal physical therapy program has failed to provide relief, and an injection several months ago provided only short-term relief. Examination reveals a positive Neer and Hawkins test. There is no instability and the neurovascular examination is normal. Arthroscopy reveals a partial rotator cuff tear on the bursal side measuring 60% of the tendon thickness. What is the next most appropriate step in management?

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Arthroscopic debridement alone of the partial rotator cuff tear

8/241

Repair of the partial rotator cuff tear and subacromial decompression

83%

200/241

Arthroscopic debridement combined with subacromial decompression

12%

29/241

Arthroscopic subacromial decompression

3/241

Biceps tenotomy

0/241

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Although arthroscopic debridement with or without subacromial decompression is a reasonable response, the patient has positive impingement signs. Several recent studies regarding the surgical treatment of partial rotator cuff tears have demonstrated good to excellent results after repair of tears involving more than 50% of the tendon thickness. This was shown specifically for bursal-sided tears and joint-side tears. Biceps tenotomy is not indicated in a young patient.