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Massive rotator cuff tears: definition and treatment

Lädermann, Alexandre ; Denard, Patrick ; Collin, Philippe

In: International Orthopaedics, 2015, vol. 39, no. 12, p. 2403-2414

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    Title
    • Massive rotator cuff tears: definition and treatment
    Author
    • Lädermann, Alexandre. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland
    • Denard, Patrick. Southern Oregon Orthopedics, Medford, OR, USA
    • Collin, Philippe. Saint-Grégoire Private Hospital Center, Boulevard Boutière 6, 35768, Saint-Grégoire Cedex, France
    Document Type
    • Postprint
    Language
    • English
    Published in
    • International Orthopaedics, 2015, vol. 39, no. 12, p. 2403-2414. Springer Berlin Heidelberg
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:331362
    Summary
    Purpose: The aim of this review is to summarise tear pattern classification and management options for massive rotator cuff tears (MRCT), as well as to propose a treatment paradigm for patients with a MRCT. Method: Data from 70 significant papers were reviewed in order to define the character of reparability and the possibility of alternative techniques in the management of MRCT. Results: Massive rotator cuff tears (MRCT) include a wide panoply of lesions in terms of tear pattern, functional impairment, and reparability. Pre-operative evaluation is critical to successful treatment. With the advancement of medical technology, arthroscopy has become a frequently used method of treatment, even in cases of pseudoparalytic shoulders. Tendon transfer is limited to young patients with an irreparable MRCT and loss of active rotation. Arthroplasty can be considered for the treatment of a MRCT with associated arthritis. Conclusion: There is insufficient evidence to establish an evidence-based treatment algorithm for MRCTs. Treatment is based on patient factors and associated pathology, and includes personal experience and data from case series.