Débridement of Small Partial-thickness Rotator Cuff Tears in Elite Overhead Throwers

Reynolds, Scott B.; Dugas, Jeffrey R.; Cain, E. Lyle; McMichael, Christopher S.; Andrews, James R.

doi:10.1007/s11999-007-0107-1

Cited by 112 publications

(86 citation statements)

References 32 publications

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“…For professional pitchers, only 45-76% return to prior level of play has been achieved, with most studies towards the lower rate [13,19,20]. Reynolds et al evaluated 82 professional throwers treated with debridement alone for partial thickness rotator cuff tears [13]. In this study, they demonstrated 76% return to Major League Baseball play, but only 55% returning to their prior level of performance.…”

Section: Treatment Outcomesmentioning

confidence: 73%

“…Return to sport rates can be 75% or greater, but return to pre-injury level of performance is usually less than 50%. For professional pitchers, only 45-76% return to prior level of play has been achieved, with most studies towards the lower rate [13,19,20]. Reynolds et al evaluated 82 professional throwers treated with debridement alone for partial thickness rotator cuff tears [13].…”

Section: Treatment Outcomesmentioning

confidence: 99%

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Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Liu

Garcia

Gowd

et al. 2018

Curr Rev Musculoskelet Med

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Purpose of Review To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. Recent Findings Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Summary Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid. The true prevalence of partial tears may be underestimated given the high incidence of asymptomatic tears. Both dynamic ultrasound and enhanced contrast MRI have improved our understanding of this pathology. For most overhead athletes, nonoperative management is the most common course. Despite advances in imaging, diagnosis, and surgical techniques, our ability to return these patients to their elite level is modest at best when nonoperative management fails and surgical treatment is performed. If a surgical route is needed, debridement alone is the most frequent procedure given concerns of over constraint and poor return to play with surgical repair of the partial thickness rotator cuff tear.

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Section: Treatment Outcomesmentioning

confidence: 73%

Section: Treatment Outcomesmentioning

confidence: 99%

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Liu

Garcia

Gowd

et al. 2018

Curr Rev Musculoskelet Med

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show abstract

“…One study reported on maximum velocity before and after surgery (debridement of partial-thickness rotator cuff tears), and demonstrated a mean decrease in velocity from 94.2 mph to 90.1 mph. 37 Unfortunately, due to concurrent diagnoses, the investigators were unable to compare return to sport for the varying surgical techniques and diagnoses, but the study does offer considerable insight into expectations when treating elite pitchers. 42 …”

Section: Return To Sport In Elite Pitchersmentioning

confidence: 99%

Return to Play After Shoulder Surgery in Throwers

Thorsness

Alland

McCulloch

et al. 2016

Clinics in Sports Medicine

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“…However, all patients in this study had labral pathology as well, and 25% had biceps pathology. Reynolds et al 62 reported positive outcomes on the debridement of small partial-thickness rotator cuff tears in overhead athletes. In their study of 67 pitchers, 76% were able to return to pitching at a professional level and 55% returned to at least the same level of competition.…”

Section: Arthroscopic Debridementmentioning

confidence: 99%

Rotator Cuff Tears in the Throwing Athlete

Shaffer

Huttman

2014

Sports Medicine and Arthroscopy Review

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Tears of the rotator cuff, both partial, and less commonly, full thickness, are relatively common in the throwing athlete. The rotator cuff is subjected to enormous stresses during repetitive overhead activity. The supraphysiological strains, especially when combined with pathology elsewhere in the kinetic chain, can lead to compromise of the cuff fabric, most commonly on the undersurface where tensile overload occurs. Exacerbation by a tight posterior capsular, anterior instability, and internal impingement render the cuff progressively compromised, with intrinsic shear stresses and undersurface fiber failure. Advances in imaging technology, including contrast magnetic resonance imaging, dynamic ultrasound, and arthroscopic visualization have enhanced our understanding of cuff pathology in this athletic population. Unfortunately, this has not yet translated into how to best approach these athletes to return them to their previous level of activity. Nonoperative management remains the mainstay for most throwers, with arthroscopic debridement an effective surgical option for those with refractory symptoms. Despite technological advances in cuff repair in the general population, comparable outcomes have not been achieved in high-level throwers. Widespread appreciation that securing the cuff operatively will likely end an athletes' throwing career has led to adopting a surgical approach that emphasizes debridement over repair for nearly all partial and full-thickness tears. Whether advances in surgical technique will ultimately permit definitive and lasting repairs that allow overhead throwers to return to their previous level of sports remains unknown at this time.

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Débridement of Small Partial-thickness Rotator Cuff Tears in Elite Overhead Throwers

Cited by 112 publications

References 32 publications

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Return to Play After Shoulder Surgery in Throwers

Rotator Cuff Tears in the Throwing Athlete

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