ObjectiveTo investigate the effectiveness of reversed arthroscopic subacromial decompression in the treatment of rotator cuff tears. MethodsBetween November 2012 and January 2015, 53 patients with rotator cuff tears were treated with reversed arthroscopic subacromial decompression and rotator cuff repair. Of 53 patients, 38 were male and 15 were female, with the age of 47-61 years (mean, 53.4 years). The injury was caused by falling in 36 cases and other in 17 cases without an obvious history of trauma. All patients had shoulder pain and limited shoulder movement before operation. Visual analogue scale (VAS) was 6.4±0.9, and University of California at Los Angeles (UCLA) score was 16.3±1.9. MRI showed that distal supraspinatus tear was observed in 41 cases and distal infraspinatus tear in 12 cases; partial-thickness rotator cuff tear was observed in 9 cases and full-thickness tear in 44 cases. And the tear size was from 1 to 3 cm (mean, 1.9 cm). Combined injuries included tendinitis of long head of biceps brachii in 31 cases, Bankart lesion in 5 cases, and superior labrum anterior and posterior lesion in 2 cases. ResultsIncision healed by first intention in all patients; no infection or nerve injury occurred. Forty-nine cases were followed up from 12 to 35 months (mean, 22.8 months). After operation, shoulder pain relief was achieved in 42 cases; 7 cases had anterior shoulder pain at 3 months after operation, which was relieved after symptomatic treatment. At last follow-up, VAS score was significantly decreased to 0.5±0.6 (t=40.565, P=0.000). UCLA score was significantly increased to 33.8±1.7 (t=-79.799, P=0.000). The results were excellent in 42 cases, good in 6 cases, and fair in 1 case; the excellent and good rate was 98.0%. ConclusionReversed arthroscopic subacromial decompression can avoid coracoacromial arch injury and achieve good recovery of joint function, so it can be used in rotator cuff tears procedure.