Management of massive and irreparable rotator cuff tears

Abstract Massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist. In this review, we will discuss the classification, diagnosis, and evaluation of massive rotator cuff tears before discussing various treatment options for this problem. Nonoperative treatment has had incons...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2009-09, Vol.18 (5), p.808-818
Main Authors: Neri, Brian R., MD, Chan, Keith W., MD, Kwon, Young W., MD, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Debridement - methods
Decompression, Surgical - methods
Disability Evaluation
Diseases of the osteoarticular system
Female
Follow-Up Studies
Humans
Injury Severity Score
irreparable
Juxtaarticular diseases. Extraarticular rhumatism
Male
management
Massive
Medical sciences
Muscle, Skeletal - transplantation
Orthopedics
Pain Measurement
Physical Therapy Modalities
Range of Motion, Articular - physiology
Recovery of Function
Risk Assessment
Rotator Cuff Injuries
rotator cuff tears
Shoulder Joint - injuries
Shoulder Joint - surgery
Shoulder Pain - etiology
Shoulder Pain - therapy
Tendon Transfer - methods
tendon transfers
Treatment Outcome
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Description
Summary:Abstract Massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist. In this review, we will discuss the classification, diagnosis, and evaluation of massive rotator cuff tears before discussing various treatment options for this problem. Nonoperative treatment has had inconsistent results and proven unsuccessful for chronic symptoms while operative treatment including débridement and partial and complete repairs have had varying degrees of success. For rotator cuff tears that are deemed irreparable, treatment options are limited. The use of tendon transfers in younger patients to reconstruct rotator cuff function and restore shoulder kinematics can be useful in salvaging this difficult problem. Level of Evidence Review Article.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2009.03.013