Massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist. In this review, we will discuss the classification, diagnosis, and evaluation of massive rotator cuff tears before discussing various treatment options for this problem. Nonoperative treatment has had inconsistent results and proven unsuccessful for chronic symptoms while operative treatment including debridement and partial and complete repairs have had varying degrees of success. For rotator cuff tears that are deemed irreparable, treatment options are limited. The use of tendon transfers in younger patients to reconstruct rotator cuff function and restore shoulder kinematics can be useful in salvaging this difficult problem.
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December 2024
Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea.
Background: Muscle atrophy after the rupture of a rotator cuff (RC) tendon is a major factor that increases the risk of secondary complications and re-rupture. Metformin, a type 2 diabetes treatment, can be used to modulate intracellular signaling pathways that promote muscle growth. This study aimed to verify whether systemic metformin administration could prevent supraspinatus (SS) atrophy after RC rupture in a rat model.
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Arthroscopy
December 2024
Department of Orthopaedic Surgery, Chiba University after Graduate School of Medicine.
Purpose: The purpose of this study was to evaluate the integrity of the repaired rotator cuff between 1 and 2 years postoperatively after arthroscopic rotator cuff repair (ARCR) using magnetic resonance imaging (MRI), investigate the factors affecting its change, and assess the association between the change and postoperative clinical outcomes.
Methods: Rotator cuff tear patients who underwent ARCR and were evaluated by MRI before surgery, and 1 and 2 years after ARCR with a minimum of 2-year follow-up were included in this study. Repair integrity was evaluated using Sugaya's classification, and according to the classification types IV and V were defined as re-tears.
Sling is Not-Inferior to Brace Immobilization Following Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.
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Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, 6900, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland.
Purpose: The aim of this study was to compare the safety and efficacy of immobilizing the upper limb with a brace versus a less-constrained sling in the rehabilitation after arthroscopic rotator cuff repair (ARCR), by documenting clinical and radiological results.
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Subregions of the Rotator Cuff Muscles Present Distinct Anatomy, Biomechanics, and Function.
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Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, San Antonio, TX 78249, USA.
Shoulder and elbow injuries are prevalent among baseball players, particularly pitchers, who experience repetitive eccentric loading of the shoulder, leading to muscle damage and increased injury risk. Nearly 40% of shoulder injuries in baseball occur in pitchers, with many facing low rates of return to sport. The rotator cuff (RC) muscles-supraspinatus (SSP), infraspinatus (ISP), subscapularis (SSC), and teres minor (TMin)-are crucial for shoulder stability, movement, and force generation, particularly in overhead sports.
View Article and Find Full Text PDFThe Transverse Humeral Ligament: An Anatomical Narrative Review.
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Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan.
Shoulder pain often involves the tendon of the long head of the biceps brachii (LHBT) and the transverse humeral ligament (THL). Traditionally, the THL is considered a ligament that prevents the LHBT from dislocating, but recent studies suggest that it may be part of the subscapularis tendon. This review evaluates the nature of the THL and its overlying structures.
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