Massive Tears: Techniques for Mobilization of the Large Retracted Rotator Cuff Tears

2019 ◽  
pp. 321-329
Author(s):  
Maristella F. Saccomanno ◽  
Giuseppe Milano
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Massive Tears

scholarly journals Classification Systems in Rotator Cuff Tears

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ram Chidambaram ◽  
Reet Mukhopadhyay
Keyword(s):  
Rotator Cuff ◽  
Review Article ◽  
Classification Systems ◽  
Rotator Cuff Tears ◽  
Rotator Cuff Tendon ◽  
Cuff Tear ◽  
Orthopedic Literature ◽  
Comprehensive Classification ◽  
Tear Size ◽  
Massive Tears

Rotator cuff pathology is one of the most common conditions affecting the shoulder joint. Several classification systems have been used to describe rotator cuff tears in orthopedic literature. However, no comprehensive classification inclusive of all types and characteristics currently exists. Rotator cuff tears are classified based on various parameters. These include: 1. Tear depth 2. Tear Size/Extent 3. Tear Retraction 4. Tendon Quality 5. Tear Progression 6. Arthroscopic Classification. This review article aims to establish an algorithm based on the various existing classification systems so as to arrive at the best surgical or non-surgical solution as well as prognosticate the patient regarding the outcome. Special consideration needs to be made for massive tears which are irreparable. Keywords: Rotator cuff tears; Rotator cuff tear classification; Massive irreparable rotator cuff tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.

Does strength deficit correlate with shoulder function in patients with rotator cuff tears? Characteristics of massive tears

2019 ◽  
Vol 28 (10) ◽  
pp. 1861-1868
Author(s):  
Joo Han Oh ◽  
Jong Pil Yoon ◽  
Dong Hyun Kim ◽  
Seok Won Chung ◽  
Joon Yub Kim ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Massive Tears

scholarly journals Tendon Repair Leads to better Long-Term Clinical Outcome than Debridement in Massive Rotator Cuff Tears

2017 ◽  
Vol 11 (1) ◽  
pp. 546-553 ◽  
Author(s):  
Matthias Alexander König ◽  
Volker Alexander Braunstein
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcome ◽  
Tendon Repair ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Short Term ◽  
Massive Rotator Cuff Tears ◽  
Massive Tears

Introduction: Massive tears in the rotator cuff are debilitating pathologies normally associated with loss of function and pain. Tendon reconstruction is seen as the standard treatment in order to preserve shoulder function and to inhibit cuff associated osteoarthritis. However, the effect on longer-term shoulder function and patient satisfaction is unknown. Material and Methods: 165 consecutive patients with massive tears were included. 57 debridement (mean age 61.9±8.7 years (range 43-77)) and 108 reconstruction (mean age 57.5±8.9 years (range 45-74)) cases could be followed up 2-4 (short-term), 5-6 (mid-term) and 8-10 (long-term) years after surgery. Evaluation was performed with the Constant, a modified ASES and the DASH score. Statistical analysis was done using Sigma-Stat Version 3.5 with a p-value<0.05 indicating statistical significant differences. Results: All three scoring systems showed no significant differences in the short-term follow-up for the two groups (mean values: Constant debridement/repair: 70±11.9/66±13.6; ASES debridement/repair: 22.3±3.3/ 23.3±3.3; DASH debridement/repair: 22.3±11.0/ 24.3±10.1). In the mid-term (Constant debridement/repair: 51±2.9/68.3±5.2; ASES debridement/repair: 20.3±1.3/24.3±1.7; DASH debridement/repair: 31.0±6.5/20.3±5.4) and long-term follow-up (Constant debridement/repair: 42.3±3.8 /60.7±2.6, ASES debridement/repair: 17.3±0.5/21.7±0.5, DASH debridement/repair: 41.3±6.2/25.0±1.4), rotator cuff reconstruction revealed better objective results and better patients’ satisfaction. Conclusion: Rotator cuff tendon repair leads to better long-term clinical outcome and subjective satisfaction compared to debridement. Tendon reconstruction should be considered as a treatment for patients suffering from massive rotator cuff tears, thus preserving shoulder function and by that means delay indication for reverse arthroplasty.

scholarly journals Lateral Acromioplasty has a Positive Impact on Rotator Cuff Repair in Patients with a Critical Shoulder Angle Greater than 35 Degrees

2020 ◽  
Vol 9 (12) ◽  
pp. 3950
Author(s):  
Edoardo Franceschetti ◽  
Edoardo Giovannetti de Sanctis ◽  
Alessio Palumbo ◽  
Riccardo Ranieri ◽  
Paola Casti ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Mathematical Formula ◽  
Plain Radiographs ◽  
Critical Shoulder Angle ◽  
Group A ◽  
Cuff Repair ◽  
Shoulder Angle ◽  
Massive Tears

Background: A Critical Shoulder Angle (CSA), evaluated on plain radiographs, greater than 35° is considered predictive of rotator cuff tears. The present prospective comparative study aimed, firstly, to develop a formula to calculate the amount of acromion that should be resected performing a lateral acromioplasty and, secondly, verify whether lateral acromioplasty to reduce the CSA associated with arthroscopic cuff repair decreased the rate of recurrence of the tears, and impacted favorably on clinical postoperative outcomes. Methods: Patients undergoing arthroscopic rotator cuff repair (RCR) for rotator cuff tears with a CSA greater than 35° were included in this study and divided into two groups, based on whether the CSA had been reduced by arthroscopic resection of the lateral portion of the acromion. A new mathematical formula was developed in order to quantify the amount of bone to be resected while performing the lateral acromioplasty. Patients with traumatic tears, previous surgery, osteoarthritis or plain radiographs, not classified as A1 according to Suter-Henninger, were excluded. Clinical and radiographic outcomes were assessed at a minimum of 2 years of follow-up considering the tear size. Results: 289 patients were included in this study. Thirty-seven were lost to follow-up. Group A (Lateral acromioplasty) patients included: 38 small tears, 30 medium tears, 28 large tears and 22 massive tears; Group B (control group) was composed of 40 small tears, 30 medium tears, 30 large tears and 23 massive tears. The Constants Score value and retear Rate were, respectively, significant higher (p = 0.007 and p = 0.004) and lower (p = 0.029 and p = 0.028) in Group A, both in the Small-and Medium-size subgroups. No complications were outlined. The mediolateral width of the acromion was reduced, according to the preoperatively calculated measure. Conclusion: Arthroscopic lateral acromioplasty decreased the CSA within the favorable range (30°–35°) in all patients treated, resecting the amount of bone predicted by the mathematical formula. Lateral acromioplasty is a safe and reproducible technique which may prevent recurrence of rotator cuff tears in patients with small and medium lesions. Level of evidence: II.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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