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Published in: International Orthopaedics 12/2015

01-12-2015 | Original Paper

Massive rotator cuff tears: definition and treatment

Authors: Alexandre Lädermann, Patrick J. Denard, Philippe Collin

Published in: International Orthopaedics | Issue 12/2015

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Abstract

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.
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Metadata
Title
Massive rotator cuff tears: definition and treatment
Authors
Alexandre Lädermann
Patrick J. Denard
Philippe Collin
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 12/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2796-5

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