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Review
. 2014 Nov 18;5(5):557-65.
doi: 10.5312/wjo.v5.i5.557.

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder

Cameron M Anley  1 , Samuel Kl Chan  1 , Martyn Snow  1
Affiliations
Review

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder

Cameron M Anley et al. World J Orthop. .

Abstract

The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer (Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit. The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients.

Keywords: Arthroscopy; Irreparable; Massive; Repair; Rotator cuff.

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Figures

Figure 1
Figure 1
Arthroscopic view of a superior capsular repair with (A) the irreparable rotator cuff, (B) attachment of the Graftjacket to the superior glenoid and (C) Attachment of the Graftjacket to the rotator cuff footprint.
Figure 2
Figure 2
Inspace balloon insertion system.
Figure 3
Figure 3
An illustration of the Inspace balloon between the acromion and the humeral head.
See this image and copyright information in PMC

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