Kucirek Natalie K, Confino Jamie E, Feeley Brian, Davies Michael R
UCSF Department of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA.
Curr Rev Musculoskelet Med. 2025 May 5. doi: 10.1007/s12178-025-09970-x.
This review aims to summarize the epidemiology, associated pathology, and treatment options for rotator cuff tears following shoulder dislocations and to provide a treatment algorithm for these complex injuries.
Rotator cuff tears after shoulder dislocations most often occur in patients older than 40 and may be more prevalent in women. Up to 50% of these patients may have concomitant Bankart lesions. Patients treated nonoperatively generally have worse functional outcomes and higher pain scores than those who undergo rotator cuff repair. However, further studies are needed to elucidate when the rotator cuff can be repaired in isolation versus in combination with capsulolabral stabilization. Reverse total shoulder arthroplasty is a viable treatment option for elderly patients with irreparable cuff tears after dislocation or post-instability arthropathy. Patients who sustain a shoulder dislocation should be evaluated for a rotator cuff tear, particularly if older than 40. Those with post-instability full-thickness rotator cuff tears benefit from surgical treatment. Further research is needed to clarify when additional stabilization procedures should be performed alongside rotator cuff repair.
本综述旨在总结肩关节脱位后肩袖撕裂的流行病学、相关病理学及治疗选择，并为这些复杂损伤提供治疗方案。
肩关节脱位后的肩袖撕裂最常发生于40岁以上患者，在女性中可能更为常见。这些患者中高达50%可能合并Bankart损伤。与接受肩袖修复的患者相比，非手术治疗的患者通常功能预后较差且疼痛评分较高。然而，需要进一步研究以阐明何时可单独修复肩袖，以及何时应与关节囊盂唇稳定术联合修复。对于脱位后或不稳定后关节病导致肩袖撕裂无法修复的老年患者，反式全肩关节置换术是一种可行的治疗选择。发生肩关节脱位的患者应评估是否存在肩袖撕裂，尤其是年龄超过40岁者。不稳定后全层肩袖撕裂的患者从手术治疗中获益。需要进一步研究以明确何时应在肩袖修复的同时进行额外的稳定手术。
