Rotator cuff tears: pathology and repair

By virtue of its anatomy and function, the rotator cuff is vulnerable to considerable morbidity, often necessitating surgical intervention. The factors contributing to cuff disease can be divided into those extrinsic to the rotator cuff (most notably impingement) and those intrinsic to the cuff (age...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2009-04, Vol.17 (4), p.409-421
Main Authors: Yadav, Hemang, Nho, Shane, Romeo, Anthony, MacGillivray, John D.
Format: Article
Language:English
Subjects:
Age
Anatomy
Animals
Collagen
Diseases
Epidemiology
Evidence-Based Medicine
Humans
Inflammation
Literature reviews
Medicine
Medicine & Public Health
Morphology
Nicotine
Orthopedic Procedures - instrumentation
Orthopedic Procedures - methods
Orthopedic Procedures - rehabilitation
Orthopedics
Oxidative Stress
Pace
Pathology
Rotator cuff
Rotator Cuff - pathology
Rotator Cuff - physiopathology
Rotator Cuff - surgery
Rotator Cuff Injuries
Shoulder
Sports
Surgeons
Surgery
Suture Anchors
Suture Techniques - instrumentation
Sutures
Techniques
Tendon Injuries - diagnosis
Tendon Injuries - pathology
Tendon Injuries - physiopathology
Tendon Injuries - surgery
Tissue Transplantation - methods
Treatment Outcome
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Summary:By virtue of its anatomy and function, the rotator cuff is vulnerable to considerable morbidity, often necessitating surgical intervention. The factors contributing to cuff disease can be divided into those extrinsic to the rotator cuff (most notably impingement) and those intrinsic to the cuff (age-related degeneration, hypovascularity and inflammation amongst others). In an era of emerging biologic interventions, our interventions are increasingly being modulated by our understanding of these core processes, many of which remain uncertain today. When we do intervene surgically, the techniques we employ are particularly challenging in the context of the tremendous pace of advancement. Several recent studies have shown that arthroscopic repair gives similar functional results to that of mini-open and open procedures, with all the benefits of minimally invasive surgery. However, the ‘best’ repair construct remains unknown, with wide variations in surgeon preference. Here we present a literature review encompassing recent developments in our understanding of basic science in rotator cuff disease as well as an up-to-date evidence-based comparison of different techniques available to the surgeon for cuff repair.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-008-0686-8