Management of Massive Rotator Cuff Tears Without Arthropathy

• Published in: Orthopedics (Thorofare, N.J.) Vol. 46; no. 1; pp. e1 - e12
• Main Authors: Campbell, Richard E, Lee, Donghoon, Day, Louis M, Dixit, Anant, Freedman, Kevin B, Tjoumakaris, Fotios P
• Format: Journal Article
• Language: English
• Published: United States Slack, Inc 01-01-2023; SLACK INCORPORATED
• Subjects: Analysis; Arthritis; Arthroscopy - methods; Care and treatment; Contraindications; Debridement; Decision-making; Diagnosis; Graft rejection; Health aspects; Humans; Joint Diseases; Joint surgery; Medical care, Cost of; Patient outcomes; Patients; Prevention; Risk factors; Rotator cuff; Rotator Cuff - surgery; Rotator Cuff Injuries - diagnostic imaging; Rotator Cuff Injuries - surgery; Rotator cuff repair; Shoulder injuries; Surgical techniques; Sutures; Tendons; Tendons - surgery; Treatment Outcome; United States
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20220719-02

Arthroplasty is not an optimal treatment for massive rotator cuff tears in patients who are active and without glenohumeral arthritis. Several surgical techniques have been developed for these patients, including arthroscopic rotator cuff repair with single-/double-row repair (with or without interval slides, margin convergence, graft augmentation), graft bridging, superior capsular reconstruction, tuberoplasty, and tendon transfers. Complete, tension-free, anatomic repair is ideal; however, tendon atrophy and retraction associated with massive tears often complicate repairs. All surgical treatments significantly increase patient-reported functional outcomes 1 year after intervention, with many treatments demonstrating improved mid-term and long-term outcomes. [
. 2023;46(1):e1-e12.].