Arthroscopic Partial Repair of Irreparable, Massive Rotator Cuff Tears

Castricini, Roberto; Galasso, Olimpio; Riccelli, Daria Anna; Familiari, Filippo; Benedetto, Massimo De; Orlando, Nicola; Gasparini, Giorgio

doi:10.1016/j.eats.2016.09.020

Cited by 18 publications

(9 citation statements)

References 9 publications

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“…The treatment of massive irreparable rotator cuff tears is a challenge to shoulder surgeons 1, 2, 3 4 arthroscopic debridement and biceps tenotomy,5, 6 rotator cuff partial repair,6, 7, 8 patch augmentation,9, 10, 11, 12 reverse total shoulder arthroplasty,13, 14, 15 and superior capsular reconstruction 16, 17, 18, 19, 20. Superior capsular reconstruction is a good treatment option for relatively young patients with irreparable massive cuff tear because the superior capsule is the superior restraint to proximal migration of the humeral head 21 .…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Kim

Jang

Park

et al. 2019

Arthroscopy Techniques

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Many options have been developed to treat irreparable massive cuff tears. Superior capsular reconstruction has been reported as one of the treatment options for relatively young patients with irreparable massive cuff tear. However, this original technique has a disadvantage of requiring a tensor facia lata autograft. It requires another incision at the lateral thigh and can be a cause of thigh pain. This article describes our modified technique for arthroscopic superior capsule reconstruction using the biceps autograft to preserve the long head of the biceps tendon anchors to the glenoid labrum (the snake technique).

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Section: Introductionmentioning

confidence: 99%

Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Kim

Jang

Park

et al. 2019

Arthroscopy Techniques

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“…Large to massive tears of rotator cuff tendons usually cause atrophy and fatty degeneration of the rotator cuff muscles and painful loss of shoulder function. Several treatment options for large to massive rotator cuff tears (RCTs) exist; they include arthroscopic partial repair, 1 , 2 , 3 tuberoplasty, 4 , 5 debridement 3 , 6 with possible biceps tenotomy, tenodesis or augmentation, 7 , 8 tendon transfer, 9 , 10 , 11 superior capsular reconstruction, 12 , 13 , 14 , 15 , 16 patch augmentation, 17 , 18 , 19 , 20 bridging rotator cuff reconstruction with a graft, 21 and reverse total shoulder arthroplasty. 22 , 23 , 24 Despite all of these options, large to massive RCTs are still difficult to manage and treat effectively.…”

mentioning

confidence: 99%

Arthroscopic In Situ Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon

Kim

Lee

Park

et al. 2018

Arthroscopy Techniques

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Large to massive rotator cuff tears are challenging to repair, although there are several options for dealing with them. Among them, superior capsular reconstruction was recently introduced as an effective procedure for retaining the static stability of the shoulder joint and preventing the progression to cuff tear arthropathy. The purpose of this technique-based article is to describe a surgical option, called arthroscopic in situ superior capsular reconstruction, for large to massive rotator cuff tears using the long head of the biceps tendon.

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“…Although the supraspinatus is left unrepaired, complete coverage of the humeral head is unnecessary because the biomechanics of the shoulder are restored with repair of the infraspinatus and subscapularis. This technique was originally described as an open procedure, although several recent advancements 5,9,12,16 using the same principles have allowed surgeons to arthroscopically perform partial tendon repair as well as to repair different combinations of tendon tears. This procedure is typically indicated in patients with an irreparable supraspinatus and a reparable infraspinatus and subscapularis who lack glenohumeral arthritis and who continue to have pain and dysfunction after conservative management.…”

Section: Partial Repairmentioning

confidence: 99%

Nonarthroplasty Surgical Treatment Options for Massive, Irreparable Rotator Cuff Tears

Carver

Kraeutler

Smith

et al. 2018

Orthopaedic Journal of Sports Medicine

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Massive, irreparable rotator cuff tears (MIRCTs) provide a significant dilemma for orthopaedic surgeons. One treatment option for MIRCTs is reverse total shoulder arthroplasty. However, other methods of treating these massive tears have been developed. A search of the current literature on nonoperative management, arthroscopic debridement, partial repair, superior capsular reconstruction (SCR), graft interposition, balloon spacer arthroplasty, trapezius transfer, and latissimus dorsi transfer for MIRCTs was performed. Studies that described each surgical technique and reported on clinical outcomes were included in this review. Arthroscopic debridement may provide pain relief by removing damaged rotator cuff tissue, but no functional repair is performed. Partial repair has been suggested as a technique to restore shoulder functionality by repairing as much of the rotator cuff tendon as possible. This technique has demonstrated improved clinical outcomes but also fails at a significantly high rate. SCR has recently gained interest as a method to prohibit superior humeral head translation and has been met with encouraging early clinical outcomes. Graft interposition bridges the gap between the retracted tendon and humerus. Balloon spacer arthroplasty has also been recently proposed and acts to prohibit humeral head migration by placing a biodegradable saline-filled spacer between the humeral head and acromion; it has been shown to provide good clinical outcomes. Both trapezius and latissimus dorsi transfer techniques involve transferring the tendon of these respective muscles to the greater tuberosity of the humerus; these 2 techniques have shown promising restoration in shoulder function, especially in a younger, active population. Arthroscopic debridement, partial repair, SCR, graft interposition, balloon spacer arthroplasty, trapezius transfer, and latissimus dorsi transfer have all been shown to improve clinical outcomes for patients presenting with MIRCTs. Randomized controlled trials are necessary for confirming the efficacy of these procedures and to determine when each is indicated based on specific patient and anatomic factors.

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Arthroscopic Partial Repair of Irreparable, Massive Rotator Cuff Tears

Cited by 18 publications

References 9 publications

Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Arthroscopic In Situ Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon

Nonarthroplasty Surgical Treatment Options for Massive, Irreparable Rotator Cuff Tears

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