Vilela José Carlos Souza, Medeiros Filho João Felipe de, Barbosa Tadeu Fonseca, Deligne Lucas de Castro Melo, Machado Thalles Leandro de Abreu
Grupo de Cirurgia do Ombro, Hospital Unimed BH, Belo Horizonte, MG, Brasil.
Grupo de Ombro, Hospital Mater Dei, Belo Horizonte, MG, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Sep 4;59(4):e489-e496. doi: 10.1055/s-0044-1788784. eCollection 2024 Aug.
Rotator cuff tear is a common source of pain and disfunction in shoulder, with prevalence increasing with age. Nonsurgical treatment is adequate for many patients; however, for those for whom surgical treatment is indicated, rotator cuff repair provides reliable pain relief and good functional results. However, massive and irreparable tears due to tear size, tendon retraction, muscle atrophy, fatty infiltration are a significant challenge for surgeons. Whenever irreparable tears coexist with cartilage degeneration/arthritis (rotator cuff arthropathy), the indication of reverse shoulder arthroplasty is the golden standard. However, in young patients without arthritis, joint preserving procedures, from debridement to muscle transfers, are preferred. Choosing the most appropriate treatment is not quite established in literature, each treatment modality present particular indications, advantages and disadvantages.
肩袖撕裂是肩部疼痛和功能障碍的常见原因，其患病率随年龄增长而增加。非手术治疗对许多患者来说是足够的；然而，对于那些需要手术治疗的患者，肩袖修复能提供可靠的疼痛缓解和良好的功能结果。然而，由于撕裂大小、肌腱回缩、肌肉萎缩、脂肪浸润导致的巨大且无法修复的撕裂，对外科医生来说是一项重大挑战。当无法修复的撕裂与软骨退变/关节炎（肩袖关节病）并存时，反式肩关节置换术是黄金标准。然而，在没有关节炎的年轻患者中，从清创到肌肉转移的保关节手术是首选。在文献中尚未完全确定选择最合适的治疗方法，每种治疗方式都有其特定的适应症、优点和缺点。
