J Korean Orthop Assoc.  2013 Feb;48(1):61-69. 10.4055/jkoa.2013.48.1.61.

Treatment of Massive Rotator Cuff Tears: Focusing on Arthroscopic Approach

• Lee SW
• Shon MS
• Yoo JC

• KMID: 2106666
• DOI: http://doi.org/10.4055/jkoa.2013.48.1.61

Abstract

There are no standard guidelines for treatment of massive rotator cuff tears. In this article, we reviewed the various modalities for treatment of massive rotator cuff tears, especially focusing on arthroscopic treatment. Selection of one of a variety of treatment modalities is essential for understanding pathogenesis, biomechanics and reparability of massive rotator cuff tears. The best clinical results have been reported with arthroscopic complete repair of massive rotator cuff tear. Satisfactory results have also been reported with other various arthroscopic treatment methods, including simple debridement, partial repair, biceps tenotomy or tendesis, and augmentation using a tissue substitution. However few long-term follow up results are available with these salvage options. Treatment of massive rotator cuff tears is difficult due to high incidence of irreparable tears and re-tear rate. Thus, understanding the advantages and disadvantages of various treatment modalities is thought to be helpful to improving the outcome of treatment of massive rotator cuff tears.

Keyword

rotator cuff; massive tear; arthroscopy

MeSH Terms

Arthroscopy
Biomechanics
Debridement
Follow-Up Studies
Incidence
Rotator Cuff
Tenotomy

Figure

• 

  Figure 1 (A) Pre-operative magnetic resonance imaging shows a massive rotator cuff tear with severe tendon retraction and (B) fatty degeneration. (C) Arthroscopic finding of the same patient shows severe retraction of tendons. (D) Rotator cuff tendons could not be restored to the original footprint, despite of mobilization; therefore partial repair was performed. H, humeral head; G, Glenoid; SS, supraspinatus; SC, subscapularis; IS, infraspinatus; TM, teres minor.

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