Surgical management of irreparable rotator cuff tears

Franceschi, Francesco; Papalia, Rocco; Vasta, Sebastiano; Leonardi, Francesco; Maffulli, Nicola; Denaro, Vincenzo

doi:10.1007/s00167-012-2317-7

Cited by 65 publications

(61 citation statements)

References 31 publications

(53 reference statements)

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“…This unexpected finding may be due to the limited size of the radiographic cohort (n 102) and, particularly, to the relatively small number of retears observed (n 32), although the present series represents one of the largest cohorts of massive rotator cuff tears with longterm MRI assessment. The outcomes of surgical repairs of massive rotator cuff tears have improved over the years, thanks to advances in operative techniques and materials 11,22,43 .…”

Section: Discussionmentioning

confidence: 99%

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

Collin

Colmar²,

Thomazeau

et al. 2018

The Journal of Bone and Joint Surgery

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Section: Discussionmentioning

confidence: 99%

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

Collin

Colmar²,

Thomazeau

et al. 2018

The Journal of Bone and Joint Surgery

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“…28 In a study by Franceschi et al, patients with massive rotator cuff tear received either debridement or a partial repair. 29 Postoperatively, both groups demonstrated highly significant improvements compared to pre-operative values, and all scores in the partial repair group were superior to the outcome of the debridement group. These differences may be a result of the ability of the partial repair to restore the functional anatomy of the shoulder, allowing a near-tonormal arc of movement, strength and function.…”

Section: Introductionmentioning

confidence: 81%

No prosthetic management of massive and irreparable rotator cuff tears

2014

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A massive rotator cuff tear is not necessarily irreparable. Number of tendons involved, muscle-tendon unit quality, and decreased acromionhumeral distance (AHD) are as important as tear size in determining reparability of lesion. Massive and irreparable rotator cuff tears cannot be anatomically repaired to the bone and are a common source of pain and disability even in middle-aged patients. In these patients when conservative management has failed, it is possible to perform different surgical techniques. A functional repair can help to restore the horizontal force couple of the cuff on the humeral head and to increase the AHD. Debridement of irreparable tears and biceps tenotomy or tenodesis can have a role in low functional demand patients but results deteriorate over time. Recently, several commercially available tissue-engineered biological and synthetic scaffolds have been developed to augment rotator cuff repairs. The aim is to provide a mechanical improvement in case of poor quality tissue at time zero and give a support to have a better cuff healing. In selected cases, the scaffold can be used also to bridge tendon defect. Patients who not have pseudoparalysis, cuff tear arthropathy and with intact deltoid function can benefit from tendon transfers with satisfactory outcomes. These different procedures should be chosen for each patient with selected criteria and after a satisfactory explanation about the really possible expectation after surgery.

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“…During repair of a massive rotator cuff tear, anatomical restoration of the cuff is always the goal as complete repair is associated with a better functional outcome [1, 7, 10]. However, this is not always possible with native tissue in the setting of poor tissue quality and bony defects.…”

Section: Discussionmentioning

confidence: 99%

Achilles tendon allograft for an irreparable massive rotator cuff tear with bony deficiency of the greater tuberosity

Lädermann

Denard

Abrassart

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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Management of combined bony and tendinous deficiency of the posterosuperior rotator cuff represents a challenge in young patients. In this case report, a 44-year-old woman that presented an osteonecrosis of the greater tuberosity had a pseudoparalytic shoulder. She beneficiated from a fresh-frozen Achilles tendon allograft with calcaneal bone, which was used to reconstruct the rotator cuff and the concomitant bony defect. At 12-month follow-up, the patient was pain free and had complete range of motion, normal strength, a SANE score of 95 and radiographically the allograft was healed. An Achilles tendon allograft may therefore be a viable surgical option to reconstruct a combine posterosuperior rotator cuff tear and greater tuberosity bone defect. Level of evidence IV.

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Surgical management of irreparable rotator cuff tears

Abstract: Therapeutic case-control study, Level III.

Cited by 65 publications

References 31 publications

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

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

No prosthetic management of massive and irreparable rotator cuff tears

Achilles tendon allograft for an irreparable massive rotator cuff tear with bony deficiency of the greater tuberosity

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