‘Irreparable’ Rotator Cuff Tears: Tips and Tricks to Achieve Arthroscopic Repair
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Published:
Aug 31, 2022
Keywords:
Tendon injury, rotator cuff, tendon repair, arthroscopy
Main Article Content
Abstract
Irreparable rotator cuff tears are major injuries that can drastically affect the quality of life of the patients. Despite the complexity of the procedure and the high rates of re-tear, surgical repair is justified due to the lack of less aggressive and palliative alternatives. If a repair is not achieved, surgical alternatives are considered including tendon transfer, superior capsular reconstruction, or even reverse shoulder arthroplasty. Accordingly, arthroscopic repair must be performed in order to save the severely injured rotator cuff. The aim of this study is to summarize some of the arthroscopic techniques for repairing the so-called irreparable rotator cuff tears.
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How to Cite
Sánchez-Losilla , C., Ferré-Aniorte, A., Ramírez-Haua , J., Álvarez-Díaz , P., Cugat , R., & Alentorn-Geli , E. (2022). ‘Irreparable’ Rotator Cuff Tears: Tips and Tricks to Achieve Arthroscopic Repair. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(4), 559-569. https://doi.org/10.15417/issn.1852-7434.2022.87.4.1604
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Review article
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References
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11. Szöllösy G, Rosso C, Fogerty S, Petkin K, Lafosse L. Subacromial spacer placement for protection of rotator cuff repair. Arthrosc Tech 2014;3(5):e605-e609. https:/doi.org/10.1016/j.eats.2014.06.017
12. Ruiz Ibán MA, Sanchez Alepuz E, Diaz Heredia J, Hachem AI, Ezagüi Bentolila L, Calvo A, et al. Footprint
preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A
randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2021;29(7):2249-56. https://doi.org/10.1007/s00167-020-06073-7 Erratum in: Knee Surg Sports Traumatol Arthrosc 2022;30(3):1122.
https:/doi.org/10.1007/s00167-020-06118-x
13. Jackson M, Sylvestre E, Bleau J, Allard P, Begon M. Estimating optimal shoulder immobilization postures
following surgical repair of massive rotator cuff tears. J Biomech 2013;46(1):179-82. https://doi.org/ 10.1016/j.jbiomech.2012.09.026
14. Jerosch J, Castro WH. [Stress on the rotator cuff sutures in relation to joint position]. Z Orthop Ihre Grenzgeb
1993;131(4):317-22. https://doi.org/10.1055/s-2008-1040032 [En alemán]
15. DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 1984;66(4):563-7. PMID: 6707035
16. Elhassan BT, Alentorn-Geli E, Assenmacher AT, Wagner ER. Arthroscopic-assisted lower trapezius tendon transfer for massive irreparable posterior-superior rotator cuff tears: surgical technique. Arthrosc Tech 2016;5(5):e981-88. https://doi.org/10.1016/j.eats.2016.04.025
17. Elhassan BT, Sánchez-Sotelo J, Wagner ER. Outcome of arthroscopically assisted lower trapezius transfer to
reconstruct massive irreparable posterior-superior rotator cuff tears. J Shoulder Elbow Surg 2020;29(10):2135-42.
https://doi.org/10.1016/j.jse.2020.02.018
2. Hamada K, Yamanaka K, Uchiyama Y, Mikasa T, Mikasa M. A radiographic classification of massive rotator cuff
tear arthritis. Clin Orthop Relat Res 2011;469:2452-60. https://doi.org/10.1007/s11999-011-1896-9
3. Goutallier D, Postel J-M, Bernageau J, Lavau L, Voisin M-C. Fatty muscle degeneration in cuff ruptures. Clin
Orthop Relat Res 1994:78-83. PMID: 8020238
4. Khair MM, Gulotta LV. Treatment of irreparable rotator cuff tears. Curr Rev Musculoskelet Med 2011;4(4):208-13. https://doi.org/10.1007/s12178-011-9098-3
5. Peláez DP, Ortega AE, Flores A, Barón MG. Espaciador subacromial para el tratamiento artroscópico del desgarro masivo del manguito rotador. An Med (Mex) 2017;62(1):69-73. Disponible en: https://www.topdoctors.mx/pdf/public/1c5b943a650f1ebe1090052081d6fbea/espaciador-subacromial-para-el-tratamiento-artroscopico-del-desgarro-masivodel-manguito-rotador-presentacion-de-un-caso.pdf
6. Burkhart SS, Esch JC, Jolson RS. The rotator crescent and rotator cable: an anatomic description of the shoulder’s “suspension bridge”. Arthroscopy 1993;9(6):611-6. https://doi.org/10.1016/s0749-8063(05)80496-7. Erratum in: Arthroscopy 1994;10(2):239. https://doi.org/10.1016/S0749-8063(05)80104-5
7. Lo IK, Burkhart SS. The interval slide in continuity: a method of mobilizing the anterosuperior rotator cuff without disrupting the tear margins. Arthroscopy 2004;20(4):435-41. https://doi.org/10.1016/j.arthro.2004.01.016
8. Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am 2007;89(4):747-57. https://doiorg/10.2106/JBJS.E.01097
9. Savarese E, Romeo R. New solution for massive, irreparable rotator cuff tears: The subacromial “biodegradable
spacer”. Arthrosc Tech 2012;1(1):e69-e74. https://doi.org/10.1016/j.eats.2012.02.002
10. Senekovic V, Poberaj B, Kovacic L, Mikek M, Adar E, Dekel A. Prospective clinical study of a novel biodegradable sub-acromial spacer in treatment of massive irreparable rotator cuff tears. Eur J Orthop Surg Traumatol 2013;23(3):311-6. https://doi.org/10.1007/s00590-012-0981-4
11. Szöllösy G, Rosso C, Fogerty S, Petkin K, Lafosse L. Subacromial spacer placement for protection of rotator cuff repair. Arthrosc Tech 2014;3(5):e605-e609. https:/doi.org/10.1016/j.eats.2014.06.017
12. Ruiz Ibán MA, Sanchez Alepuz E, Diaz Heredia J, Hachem AI, Ezagüi Bentolila L, Calvo A, et al. Footprint
preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A
randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2021;29(7):2249-56. https://doi.org/10.1007/s00167-020-06073-7 Erratum in: Knee Surg Sports Traumatol Arthrosc 2022;30(3):1122.
https:/doi.org/10.1007/s00167-020-06118-x
13. Jackson M, Sylvestre E, Bleau J, Allard P, Begon M. Estimating optimal shoulder immobilization postures
following surgical repair of massive rotator cuff tears. J Biomech 2013;46(1):179-82. https://doi.org/ 10.1016/j.jbiomech.2012.09.026
14. Jerosch J, Castro WH. [Stress on the rotator cuff sutures in relation to joint position]. Z Orthop Ihre Grenzgeb
1993;131(4):317-22. https://doi.org/10.1055/s-2008-1040032 [En alemán]
15. DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 1984;66(4):563-7. PMID: 6707035
16. Elhassan BT, Alentorn-Geli E, Assenmacher AT, Wagner ER. Arthroscopic-assisted lower trapezius tendon transfer for massive irreparable posterior-superior rotator cuff tears: surgical technique. Arthrosc Tech 2016;5(5):e981-88. https://doi.org/10.1016/j.eats.2016.04.025
17. Elhassan BT, Sánchez-Sotelo J, Wagner ER. Outcome of arthroscopically assisted lower trapezius transfer to
reconstruct massive irreparable posterior-superior rotator cuff tears. J Shoulder Elbow Surg 2020;29(10):2135-42.
https://doi.org/10.1016/j.jse.2020.02.018