Decreased range of motion, as found in FAI, is not solely dependent on the size or even the occurrence of a cam lesion but should be interpreted by taking into account the overall hip anatomy, specifically femoral version and acetabular coverage. Decreased femoral anteversion and increased acetabular coverage add to the risk of early femoroacetabular collision during sports and activities of daily living and therefore appear to be additional predictive variables, besides the finding of a cam lesion, for the risk of clinical hip impingement development. In addition, the findings suggest that surgical osteochondroplasty to restore a normal range of motion may necessitate more excessive bone resection than what simply appears to be a bump on imaging.

In the present prospective study, we report about our experience with massive rotator cuff tears treated by means of a non-resorbable transosseously fixated patch combined with subacromial decompression. Forty-one patients were followed clinically and radiographically for a mean duration of 43 months. Their mean preoperative Constant and Murley score improved (P<0.001) from 25.7 preoperatively to 72.1 postoperatively. Substantial pain relief and improvement in the performance of activities of daily living were obtained. Anatomically, the repair resulted in a mean acromiohumeral interval of 8.6 mm. At the latest follow-up, three patients presented with a new tear between the inserted mesh and the supraspinatus musculotendinous unit. Reoperations were not performed. For short-term periods, restoring a massive rotator cuff tendon defect with synthetic grafts combined with subacromial decompression can give significant pain relief and improvement of range of motion and strength with few complications.

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