clinic of orthopaedics, University Hospital of Udine.
Clinica Ortopedica - ASUFC - Udine, Italy.
Acta Biomed. 2021 Jul 26;92(S3):e2021026. doi: 10.23750/abm.v92iS3.11766.
The treatment of massive rotator cuff tears poses a challenge to orthopedic surgeons. The prevalence of massive rotator cuff tears is 40% of all rotator cuff tears. Compared with smaller tears, massive rotator cuff tears are often complicated by structural failure and poor outcomes and present a higher rate of recurrent tearing after surgical repair. Several management options are available but the selection of the most appropriate treatment for each patient can be challenging. To achieve the best outcomes, the orthopedic surgeon should have a good understanding of the indications, the pathomechanics and the clinical outcomes of the various treatment modalities. Treatment options include non-operative management, arthroscopic debridement with a biceps tenotomy or tenodesis, complete or partial repair, patch augmentation, superior capsular reconstruction, muscle/tendon transfer and reverse total shoulder arthroplasty. The purpose of this article is to review treatment options and clinical outcomes for the management of massive rotator cuff tears.
肩袖大面积撕裂的治疗对骨科医生来说是一个挑战。肩袖大面积撕裂的发生率占所有肩袖撕裂的 40%。与较小的撕裂相比，肩袖大面积撕裂常伴有结构失败和较差的结果，且在手术后修复后再次撕裂的发生率更高。有几种治疗选择，但为每个患者选择最合适的治疗方法可能具有挑战性。为了获得最佳结果，骨科医生应该充分了解各种治疗方式的适应证、病理力学和临床结果。治疗选择包括非手术治疗、关节镜下肱二头肌切断或肌腱固定术清创术、全或部分修复术、补片增强术、上囊重建术、肌肉/肌腱转移术和反式全肩关节置换术。本文旨在回顾肩袖大面积撕裂的治疗选择和临床结果。
