Current concepts in the management of massive, irreparable, rotator cuff tears
massive irreparable rotator cuff tears
Keywords:
massive, irreparable, rotator cuff tears, arthroscopy, superior capsular reconstruction, reverse shoulder arthroplastyAbstract
Massive irreparable rotator cuff tears (MIRCT) are clinical entities difficult to treat and can cause severe impairment in the shoulder joint due to pain, restricted motion, and lack of strength. Arthroscopic debridement, partial tendon repair, subacromial balloon spacer, superior capsular reconstruction (SCR), tendon transfers and reverse shoulder arthroplasty (RSA) are the commonest techniques addressing the problem depending on patient age, clinical evaluation and tendon loss. Tendon transfers and SCR have shown promising results in younger patients. In contrast, RSA and arthroscopic debridement with or without a balloon spacer are reserved for older individuals. This mini comprehensive review will discuss the above techniques’ indications, rationales, and evidence.
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References
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15. de Campos Azevedo CI, Andrade R, Leiria Pires Gago Ângelo AC, Espregueira-Mendes J, Ferreira N, Sevivas N. Fascia Lata Autograft Versus Human Dermal Allograft in Arthroscopic Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears: A Systematic Review of Clinical Outcomes. Arthroscopy. 2020;36(2):579-591.e2. doi: 10.1016/j.arthro.2019.08.033.
16. Kooistra B, Gurnani N, Weening A, van den Bekerom M, van Deurzen D. Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2019;27(12):4038-4048. doi:10.1007/s00167-019-05710-0
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18. Sellers TR, Abdelfattah A, Frankle MA. Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty. Curr Rev Musculoskelet Med. 2018;11(1):131-140. doi:10.1007/s12178-018-9467-2
19. Saraglis G, Mamarelis G, Karadaglis D. Quality of life evaluation after reverse shoulder arthroplasty: A retrospective case series of 2 and 3 years follow up. Acta Orthopaedica et Traumatologica Hellenica, 2021;72(3):250-255.
20. Varvitsiotis D, Kokkineli S, Feroussis C, Apostolopoulos N, Zakilas D, Feroussis J. Long-Term Results of Primary Reverse Shoulder Arthroplasty for Massive, Irreparable Rotator Cuff Tears Without Glenohumeral Arthritis with a Mean Follow up of 9.4 Years. J Shoulder Elb Arthroplast. 2023;7:24715492231192072. doi:10.1177/24715492231192072
2. Sheth MM, Shah AA. Massive and Irreparable Rotator Cuff Tears: A Review of Current Definitions and Concepts. Orthop J Sports Med. 2023 May 10;11(5):23259671231154452. doi: 10.1177/23259671231154452.
3. Dey Hazra ME, Dey Hazra RO, Hanson JA, et al. Treatment options for massive irreparable rotator cuff tears: a review of arthroscopic surgical options. EFORT Open Rev. 2023;8(1):35-44. doi: 10.1530/EOR-22-0015.
4. Lädermann A, Denard PJ, Collin P. Massive rotator cuff tears: definition and treatment. Int Orthop. 2015;39(12):2403-14. doi: 10.1007/s00264-015-2796-5.
5. Valenti P. Joint-preserving treatment options for irreparable rotator cuff tears. Orthopade. 2018;47(2):103-112. doi: 10.1007/s00132-017-3516-1.
6. Pogorzelski J, Rupp MC, Scheiderer B, et al. Management of Irreparable Posterosuperior Rotator Cuff Tears-A Current Concepts Review and Proposed Treatment Algorithm by the AGA Shoulder Committee. J Pers Med. 2023;13(2):191. doi:10.3390/jpm13020191
7. Ó Conaire E, Delaney R, Lädermann A, Schwank A, Struyf F. Massive Irreparable Rotator Cuff Tears: Which Patients Will Benefit from Physiotherapy Exercise Programs? A Narrative Review. Int J Environ Res Public Health. 2023;20(7):5242. doi:10.3390/ijerph20075242
8. Malahias MA, Kostretzis L, Chronopoulos E, Brilakis E, Avramidis G, Antonogiannakis E. Arthroscopic partial repair for massive rotator cuff tears: does it work? A systematic review. Sports Med Open. 2019;5(1):13. doi: 10.1186/s40798-019-0186-z.
9. Kovacevic D, Suriani RJ Jr, Grawe BM, et al. Management of irreparable massive rotator cuff tears: a systematic review and meta-analysis of patient-reported outcomes, reoperation rates, and treatment response. J Shoulder Elbow Surg. 2020;29(12):2459-2475. doi:10.1016/j.jse.2020.07.030
10. Viswanath A, Drew S. Subacromial balloon spacer - Where are we now? J Clin Orthop Trauma. 2021;17:223-232. doi: 10.1016/j.jcot.2021.03.017.
11. Stewart RK, Kaplin L, Parada SA, Graves BR, Verma NN, Waterman BR. Outcomes of Subacromial Balloon Spacer Implantation for Massive and Irreparable Rotator Cuff Tears: A Systematic Review. Orthop J Sports Med. 2019;7(10):2325967119875717. doi:10.1177/2325967119875717
12. Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29(3):459-470. doi:10.1016/j.arthro.2012.10.022
13. Kim, D. H., Jung, Y. S., Kim, K. R., & Yoon, J. P. The best options in superior capsular reconstruction. Clinics in shoulder and elbow 2021;24(2):114–121. doi.org/10.5397/cise.2021.00136
14. Claro R, Fonte H. Superior capsular reconstruction: current evidence and limits. EFORT Open Rev. 2023;8(5):340-350. doi: 10.1530/EOR-23-0027.
15. de Campos Azevedo CI, Andrade R, Leiria Pires Gago Ângelo AC, Espregueira-Mendes J, Ferreira N, Sevivas N. Fascia Lata Autograft Versus Human Dermal Allograft in Arthroscopic Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears: A Systematic Review of Clinical Outcomes. Arthroscopy. 2020;36(2):579-591.e2. doi: 10.1016/j.arthro.2019.08.033.
16. Kooistra B, Gurnani N, Weening A, van den Bekerom M, van Deurzen D. Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2019;27(12):4038-4048. doi:10.1007/s00167-019-05710-0
17. Cartucho A. Tendon transfers for massive rotator cuff tears. EFORT open reviews 2022;7(6):404–413. doi.org/10.1530/EOR-22-0023
18. Sellers TR, Abdelfattah A, Frankle MA. Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty. Curr Rev Musculoskelet Med. 2018;11(1):131-140. doi:10.1007/s12178-018-9467-2
19. Saraglis G, Mamarelis G, Karadaglis D. Quality of life evaluation after reverse shoulder arthroplasty: A retrospective case series of 2 and 3 years follow up. Acta Orthopaedica et Traumatologica Hellenica, 2021;72(3):250-255.
20. Varvitsiotis D, Kokkineli S, Feroussis C, Apostolopoulos N, Zakilas D, Feroussis J. Long-Term Results of Primary Reverse Shoulder Arthroplasty for Massive, Irreparable Rotator Cuff Tears Without Glenohumeral Arthritis with a Mean Follow up of 9.4 Years. J Shoulder Elb Arthroplast. 2023;7:24715492231192072. doi:10.1177/24715492231192072
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2025-02-21
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