Partial repair of irreparable rotator cuff tears

Burkhart, Stephen S.; Nottage, Wesley M.; Ogilvie-Harris, Darrell; Kohn, Harvey S.; Pachelli, Anthony

doi:10.1016/s0749-8063(05)80186-0

Cited by 447 publications

(262 citation statements)

References 15 publications

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“…During surgery, the tendon stump was pulled distally up to the footprint with the shoulder at 20°eleva-tion in neutral rotation after routine procedures including coracohumeral ligament release, interval slide, circumferential capsulotomy at the proximal edge, and anterior transfer of the teres minor tendon. If the tendon defect could not be closed after these procedures, it was left partially open [2] or closed with interposition of the long head of the biceps tendon or using muscle transfers, as described subsequently. Among the 41 patients treated surgically, primary closure could be performed for 20 of 26 with Grade 1 tears and eight of 15 with Grade 2 tears.…”

Section: Methodsmentioning

confidence: 99%

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A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

Hamada

Yamanaka²,

Uchiyama

et al. 2011

Clinical Orthopaedics &Amp; Related Research

246

131

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Background In 1990, Hamada et al. radiographically classified massive rotator cuff tears into five grades. Walch et al. subsequently subdivided Grade 4 to reflect the presence/absence of subacromial arthritis and emphasize glenohumeral arthritis as a characteristic of Grade 4. Questions/purposes We therefore determined (1) whether patient characteristics and MRI findings differed between the grades at initial examination and final followup; (2) which factors affected progression to a higher grade; (3) whether the retear rate of repaired tendons differed among the grades; and (4) whether the radiographic grades at final followup differed from those at initial examination among patients treated operatively. Patients and Methods We retrospectively reviewed 75 patients with massive rotator cuff tears. Thirty-four patients were treated nonoperatively and 41 operatively.

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Section: Methodsmentioning

confidence: 99%

“…Among the 15 patients with Grade 2 tears, primary repair was possible in eight. The repair was partial in one patient to restore the force couples [2]. The remaining six cuff tears were repaired using the procedures of Table 5).…”

Section: Methodsmentioning

confidence: 99%

A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

Hamada

Yamanaka²,

Uchiyama

et al. 2011

Clinical Orthopaedics &Amp; Related Research

246

131

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“…33 Additionally, with rotator cuff tear there is variability in the amount of strength deficit which appears to depend on factors other than cuff tear size. 12,13,40,41,74 Current musculoskeletal modeling paradigms have been unable to explain the variation in strength, or the strength deficit. Observations of musculoskeletal parameters also exhibit variability.…”

Section: Introductionmentioning

confidence: 99%

A Probabilistic Model of Glenohumeral External Rotation Strength for Healthy Normals and Rotator Cuff Tear Cases

et al. 2006

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The reigning paradigm of musculoskeletal modeling is to construct deterministic models from parameters of an "average" subject and make predictions for muscle forces and joint torques with this model. This approach is limited because it does not perform well for outliers, and it does not model the effects of population parameter variability. The purpose of this study was to simulate variability in musculoskeletal parameters on glenohumeral external rotation strength in healthy normals, and in rotator cuff tear cases using a Monte Carlo model. The goal was to determine if variability in musculoskeletal parameters could quantifiably explain variability in glenohumeral external rotation strength. Multivariate Gamma distributions for musculoskeletal architecture and moment arm were constructed from empirical data. Gamma distributions of measured joint strength were constructed. Parameters were sampled from the distributions and input to the model to predict muscle forces and joint torques. The model predicted measured joint torques for healthy normals, subjects with supraspinatus tears, and subjects with infraspinatus-supraspinatus tears with small error. Muscle forces for the three conditions were predicted and compared. Variability in measured torques can be explained by differences in parameter variability.

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“…광범위 파열에 대한 개방적 및 관절경적 일차 복 원술시 근에 가해지는 장력이 증가하게 되고 이로 인한 재파열의 빈도가 소파열 및 중파열에 비하여 높게 보고 되는 경향이다. 회전근 개를 충분히 유리한 후 가동성을 증가시켜 파열부에 대한 일차 복원술을 통해 회전근 개 와 상완골 간의 해부학적 복원을 얻는 것이 장기적인 결 과에 있어서 좋지만 7,24,28,29) , 퇴축이 심해 제자리로 장력 이 없는 해부학적 복원이 힘든 경우 건-건 봉합을 통한 부분 복원술을 시행하거나 6,11,41) , 내측 전이술 26,27) 등을 고 려해 볼 수도 있다. 물론 간격 활주 (interval slide) 방 식을 통한 봉합이나 10,25) 건 이전술 9,16,22,39,40) , 혹은 인공관 절 치환술 32) 을 시행할 수도 있지만 어느 방법 하나 결과 를 예측하기가 힘들고 수술 또한 부담이 되는 것이 사실 이다.…”

Section: 서 론unclassified

Debridement or Tuberoplasty for Massive Rotator Cuff Tear

Cho

Oh²,

Rhee

2010

The Journal of the Korean Shoulder and Elbow Society

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Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods:We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than 90 on flexion and abduction.

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Partial repair of irreparable rotator cuff tears

Cited by 447 publications

References 15 publications

A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

A Probabilistic Model of Glenohumeral External Rotation Strength for Healthy Normals and Rotator Cuff Tear Cases

Debridement or Tuberoplasty for Massive Rotator Cuff Tear

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