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. 2017 Jan 30;6(1):e143-e147.
doi: 10.1016/j.eats.2016.09.020. eCollection 2017 Feb.

Arthroscopic Partial Repair of Irreparable, Massive Rotator Cuff Tears

Roberto Castricini  1 , Olimpio Galasso  2 , Daria Anna Riccelli  2 , Filippo Familiari  2 , Massimo De Benedetto  1 , Nicola Orlando  1 , Giorgio Gasparini  2
Affiliations

Arthroscopic Partial Repair of Irreparable, Massive Rotator Cuff Tears

Roberto Castricini et al. Arthrosc Tech. .

Abstract

Several treatment options for chronic, massive rotator cuff tears exist, and they include debridement with possible biceps tenotomy or tenodesis, open or arthroscopic partial repair, muscle or tendon transfer, superior capsule reconstruction, synthetic patch augmentation, and reverse total shoulder arthroplasty. The aim of this technique article is to describe our preferred surgical option for irreparable, massive rotator cuff tears with an irreparable supraspinatus, a reparable infraspinatus, and an intact or reparable subscapularis tendon.

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Figures

Fig 1
Fig 1
Arthroscopic view from the posterior portal in a right shoulder in the lateral decubitus position. A massive tear of the posterosuperior rotator cuff (RC) is visualized. (HH, humeral head.)
Fig 2
Fig 2
Complete tear of supraspinatus (SSP), infraspinatus (ISP), and subscapularis (SSC) tendons. (TM, teres minor.)
Fig 3
Fig 3
Arthroscopic view from the posterior portal in a right shoulder in the lateral decubitus position. A tear of the upper third of the subscapularis tendon (SSC) is visualized. (G, glenoid; HH, humeral head.)
Fig 4
Fig 4
Arthroscopic view from the lateral portal in a right shoulder in the lateral decubitus position. A triple-loaded suture anchor (Healix) is placed as medially as possible to the first facet of the subscapularis (SSC). (HH, humeral head.)
Fig 5
Fig 5
Arthroscopic view from the posterior portal in a right shoulder in the lateral decubitus position showing a repair of the subscapularis tendon (SSC) with full coverage of the footprint on the bursal side. (HH, humeral head.)
Fig 6
Fig 6
Arthroscopic view from the posterior portal in a right shoulder in the lateral decubitus position showing placement of a triple-loaded suture anchor (Healix) for the infraspinatus (ISP) repair. (HH, humeral head.)
Fig 7
Fig 7
Arthroscopic view from the posterior portal in a right shoulder in the lateral decubitus position showing repair of the infraspinatus (ISP) with a single-row technique. (HH, humeral head.)
Fig 8
Fig 8
Anatomic repair of the posterior cuff (i.e., infraspinatus [ISP]) and the anterior cuff (i.e., subscapularis [SSC]) with the humeral head partially uncovered because of the absence of the supraspinatus (SSP). (TM, teres minor.)
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