Massive Rotator Cuff Tear Repair

Shin,  Sang Jin

doi:2010.13.1.167

Clin Shoulder Elb > Volume 13(1); 2010 > Article

Review

Journal of the Korean Shoulder and Elbow Society 2010;13(1):167-174.
DOI: https://doi.org/10.5397/CiSE.2010.13.1.167 Published online June 30, 2010.

Massive Rotator Cuff Tear Repair

Sang Jin Shin

Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea. sjshin622@ewha.ac.kr

광범위 회전근 개 파열의 봉합술

신 상 진

이화여자대학교 의학전문대학원 정형외과학교실

Abstract

PURPOSE
Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. MATERIALS AND METHODS: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan.
RESULTS
Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up.
CONCLUSION
Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.

Key Words: Massive rotator cuff tear; Repair; Retear