Clinical Relevance of Classifying Massive Rotator Cuff Tears: Results Based on Functional and Radiological Findings After Arthroscopic Repair

Abstract

Massive rotator cuff tears can be divided into 3 types: anterosuperior (group 1), posterosuperior (group 2), and anteroposterior (group 3). Each group has distinctive characteristics and shows different results in the preoperative AHD, tear size, extent of retraction, postoperative AHD, and retear rate, which provide a reasonable basis for categorization. So far, massive rotator cuff tears have only been broadly defined, consequently being understood as a single category by many. However, to clearly understand and evaluate this injury, we suggest identifying differences within the category through proper subclassification.

Clinical and MRI Outcomes 10 Years After Repair of Massive Posterosuperior Rotator Cuff Tears

“…them as tears involving ‡2 tendons and others confined them to tears of >2 tendons 6,11,14 . The tear patterns are also seldom considered, although most surgeons realize that surgical strategies and clinical outcomes depend on the geometry of the tear 13,23 . To distinguish among different tear patterns and prescribe treatment options, one of us (P.C.)…”

Increased 30-Day Postoperative Readmission and Medical Complication Rates Among Patients 65 Years and Older Following Arthroscopic Rotator Cuff Repair

“…divided massive rotator cuff tears into three types: anterosuperior, posterosuperior, and anteroposterior—and found distinctive postoperative outcomes, including retear rate relative to each tear category. 28 The positive relationship between the amount of fatty infiltration in rotator cuff muscles and postoperative complications, including nonhealing and retear has also been studied and affirmed repeatedly, 29 , 30 , 31 , 32 , 33 with preoperative grading of fatty infiltration now common practice using the Goutallier classification system. 29 As opposed to arthroplasties that replace degenerative tissue with implants, tendon-to-bone healing in rotator cuff repair does not have this option, placing considerable emphasis on the importance of repair constructs used during the procedure.…”

Effect of Anterior Acromial Coverage on Functional and Radiological Outcomes After Arthroscopic Repair of Anteroposterior Massive Rotator Cuff Tears

“…Patients were followed up in the outpatient department regularly, and standardized rehabilitation with adjustments for subjective feelings and functional capacity was y The American Journal of Sports Medicine prescribed in written form. 51 After surgery, the shoulder was immobilized with a supporting pillow, and passive range of motion (ROM) exercises were gradually allowed except for external rotation in patients with subscapularis repair (to prevent an early retear). Active ROM exercises and resistive muscle strengthening were encouraged at 6 weeks and 3 months, respectively.…”