Irreparable rotator cuff tears are common conditions seen by shoulder surgeons, characterized by a torn and retracted tendon associated with muscle atrophy and impaired mobility. Direct fixation of the torn tendon is not possible due to the retracted tendon and lack of healing potential which result in poor outcome. Several treatment options are viable but correct indication is mandatory for a good result, pain improvement, and restoration of shoulder function. Patient can be treated either with a conservative program or surgically when necessary, by different available modalities like arthroscopic debridement, partial reconstruction, subacromial spacer, tendon transfer, and shoulder replacement with reverse prosthesis. The aim of this study was to review literature to give an overview of the available possible solutions, with indications and expected outcomes.
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http://dx.doi.org/10.2147/ORR.S151259 | DOI Listing |
J Clin Med
January 2025
Shoulder and Elbow Surgery, Schulthess Clinic Zürich, 8008 Zürich, Switzerland.
: Classical reverse shoulder arthroplasty (RSA) with a high neck-shaft angle (NSA) of 155° has shown satisfactory outcomes. However, newer RSA designs aim to improve results by modifying the stem design. This study evaluates the 5-year outcomes of a stem design featuring a rectangular metadiaphyseal fixation and a 135° NSA.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Yeosu Baek Hospital, 50, Yeosu 1-ro, Yeosusi, Yeosu-si, Jeollanam-do, Republic of Korea.
Background: There are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey.
Lower trapezius tendon transfer is a surgical procedure that has become increasingly popular in recent years. The biggest advantage of this method is that the pulling direction of the lower trapezius is the same as that of the infraspinatus. Thus, the transferred lower trapezius tendon can biomechanically mimic the functions of the posterior-superior rotator cuff.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Sports Medicine Center, Department of Orthopaedic Surgery/Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Traditional superior capsular reconstruction (SCR) with biceps tendon transposition (TB) alone for irreparable massive rotator cuff tears (IMRCTs) has demonstrated a high retear rate, highlighting the need for alternative approaches. Therefore, SCR using a peroneus longus tendon graft (PLG) combined with TB (PLG-TB) should be clinically studied.
Purpose: To compare the clinical and radiological outcomes of SCR using the PLG-TB technique versus the TB technique alone for IMRCT.
The management of massive irreparable rotator cuff tears is commonly debated without consensus. With reverse shoulder arthroplasty often reserved for the older patient (older than 60 years) with rotator cuff arthropathy, treatment of the younger patient population (younger than 60 years) without arthritis is more complex. When determining a surgical approach, the clinical presentation including history and physical examination plays a vital role in the decision tree.
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