Rotator Cuff Disease: Treatment Options and Considerations

Abstract

Rotator cuff disease encompasses a broad spectrum of injury and pathology with an increasing incidence with age. Pain with overhead activity, localizing to the deltoid region, and loss of active range of motion of the shoulder are among the most common presenting symptoms. Treatment options are dependent on the extent of disease and patient symptoms, and may range from physical therapy to surgical repair using a variety of possible techniques. Tear thickness, size, and morphology frequently dictate the repair techniques that are used, such as margin convergence, anterior and posterior interval slides, and mobilization of the rotator interval and supraspinatus with a subscapularis repair. Establishing and maintaining a low-tension repair is important in optimizing tendon healing after surgery. Superior capsule reconstruction is an emerging treatment strategy for massive, otherwise irreparable cuff tears, though more long-term evidence is necessary to fully evaluate this option.

“Current concepts and expert practice report: Augmentation of rotator cuff repairs”

“…Although it may provide temporary relief, there is a lack of evidence supporting the effectiveness and improvement of long-term clinical outcomes when using subacromial corticosteroid injections. 39 Additionally, physical therapy may be of utility especially in newly diagnosed patients with symptomatic RCTs as it can addresses core and scapular strengthening issues. Application of ice, administration of nonsteroidal anti-inflammatory drugs, and avoidance of provocative maneuvers such as shoulder extension and internal rotation can be helpful in older, less active patients.…”

Rotura traumática do manguito rotador: comparação dos resultados obtidos em diferentes tempos até a abordagem

“…Das poucas vantagens, o tempo para realização de fisioterapia com intuito de fortalecer a musculatura acessória, é a mais significativa, para que a recuperação pós ciúrigica seja mais rápida e eficaz. [36,38,91].…”

Current Concepts and Recent Trends in Arthroscopic Treatment of Large to Massive Rotator Cuff Tears: A Review

“…The presence of high failure rates of rotator cuff repairs performed via traditional approaches has led to research into and development of strategies to augment the rotator cuff repair site. The goals of using augmentation in rotator cuff repairs are to enhance mechanical strength through the use of graft tissue and to promote the healing response via biologic augmentation [ 3 , 4 , 9 , 11 , 13 , 14 , 19 , 24 , 30 , 31 ].…”