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Int Orthop. 2015 Dec;39(12):2403-14. doi: 10.1007/s00264-015-2796-5. Epub 2015 May 1.

Massive rotator cuff tears: definition and treatment.

Author information

1
Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland. alexandre.laedermann@gmail.com.
2
Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland. alexandre.laedermann@gmail.com.
3
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland. alexandre.laedermann@gmail.com.
4
Southern Oregon Orthopedics, Medford, OR, USA.
5
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
6
Saint-Grégoire Private Hospital Center, Boulevard Boutière 6, 35768, Saint-Grégoire Cedex, France.

Abstract

PURPOSE:

The aim of this review is to summarise tear pattern classification and management options for massive rotator cuff tears (MRCT), as well as to propose a treatment paradigm for patients with a MRCT.

METHOD:

Data from 70 significant papers were reviewed in order to define the character of reparability and the possibility of alternative techniques in the management of MRCT.

RESULTS:

Massive rotator cuff tears (MRCT) include a wide panoply of lesions in terms of tear pattern, functional impairment, and reparability. Pre-operative evaluation is critical to successful treatment. With the advancement of medical technology, arthroscopy has become a frequently used method of treatment, even in cases of pseudoparalytic shoulders. Tendon transfer is limited to young patients with an irreparable MRCT and loss of active rotation. Arthroplasty can be considered for the treatment of a MRCT with associated arthritis.

CONCLUSION:

There is insufficient evidence to establish an evidence-based treatment algorithm for MRCTs. Treatment is based on patient factors and associated pathology, and includes personal experience and data from case series.

KEYWORDS:

Arthroscopy; Cuff tear arthropathy; Massive rotator cuff repair; Outcome; Pseudoparalysis; Reverse shoulder arthroplasty; Scores; Shoulder function; Tendon transfer

PMID:
25931202
DOI:
10.1007/s00264-015-2796-5
[Indexed for MEDLINE]

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