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Management of the Irreparable Rotator Cuff Tear.

Abstract

When evaluating patients with irreparable rotator cuff tears, orthopaedic surgeons have an increasingly wide array of surgical options, including both established techniques and emerging technologies. However, significant variability exists in the clinical evaluation and surgical indications in this subset, and definitions for pseudoparalysis and tear irreparability are inconsistent. In older patients with symptomatic rotator cuff arthropathy and relatively sedentary demands, the reverse total shoulder arthroplasty has been established as the preferred treatment option, producing reliable improvements in both pain and function. In younger patients without glenohumeral arthritis or pseudoparalysis, joint-preserving options are preferred, with recent literature highlighting alternative options including partial repair, bridging or interpositional graft placement, tendon transfers (ie, latissimus, trapezius, and pectoralis major), superior capsular reconstruction, and subacromial spacer placement. In this review article, we address the topic of irreparable rotator cuff tears, emphasizing the workup, indications for various treatment options, and clinical outcomes.

Authors+Show Affiliations

From the Ohio State University Wexner Medical Center, Columbus, OH (Dr. Cvetanovich), Wake Forest Baptist Health, Wake Forest University School of Medicine, Winston-Salem, NC (Dr. Waterman), Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL (Dr. Verma), and Rothman Institute, New York, NY (Dr. Romeo).No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31206436

Citation

Cvetanovich, Gregory L., et al. "Management of the Irreparable Rotator Cuff Tear." The Journal of the American Academy of Orthopaedic Surgeons, 2019.
Cvetanovich GL, Waterman BR, Verma NN, et al. Management of the Irreparable Rotator Cuff Tear. J Am Acad Orthop Surg. 2019.
Cvetanovich, G. L., Waterman, B. R., Verma, N. N., & Romeo, A. A. (2019). Management of the Irreparable Rotator Cuff Tear. The Journal of the American Academy of Orthopaedic Surgeons, doi:10.5435/JAAOS-D-18-00199.
Cvetanovich GL, et al. Management of the Irreparable Rotator Cuff Tear. J Am Acad Orthop Surg. 2019 Jun 14; PubMed PMID: 31206436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of the Irreparable Rotator Cuff Tear. AU - Cvetanovich,Gregory L, AU - Waterman,Brian R, AU - Verma,Nikhil N, AU - Romeo,Anthony A, Y1 - 2019/06/14/ PY - 2019/6/18/entrez PY - 2019/6/18/pubmed PY - 2019/6/18/medline JF - The Journal of the American Academy of Orthopaedic Surgeons JO - J Am Acad Orthop Surg N2 - When evaluating patients with irreparable rotator cuff tears, orthopaedic surgeons have an increasingly wide array of surgical options, including both established techniques and emerging technologies. However, significant variability exists in the clinical evaluation and surgical indications in this subset, and definitions for pseudoparalysis and tear irreparability are inconsistent. In older patients with symptomatic rotator cuff arthropathy and relatively sedentary demands, the reverse total shoulder arthroplasty has been established as the preferred treatment option, producing reliable improvements in both pain and function. In younger patients without glenohumeral arthritis or pseudoparalysis, joint-preserving options are preferred, with recent literature highlighting alternative options including partial repair, bridging or interpositional graft placement, tendon transfers (ie, latissimus, trapezius, and pectoralis major), superior capsular reconstruction, and subacromial spacer placement. In this review article, we address the topic of irreparable rotator cuff tears, emphasizing the workup, indications for various treatment options, and clinical outcomes. SN - 1940-5480 UR - https://www.unboundmedicine.com/medline/citation/31206436/Management_of_the_Irreparable_Rotator_Cuff_Tear L2 - http://dx.doi.org/10.5435/JAAOS-D-18-00199 DB - PRIME DP - Unbound Medicine ER -