[Diagnostics and treatment of anterosuperior rotator cuff tears]

Anterosuperior rotator cuff lesions are defined as combined tears of the subscapularis and the supraspinatus tendon and are usually accompanied by an associated lesion of the rotator interval. There are three different types of lesion: extended lesions of the biceps pulley, transmural tears of the supraspinatus with an associated partial lesion of the subscapularis tendon, and massive anterosuperior rotator cuff tears. None of these lesions responds well to physiotherapy because of biceps tendon instability. Therefore, surgical treatment is required, including tenodesis or tenotomy of the biceps tendon and additional repair of the rotator cuff. Deep partial tears of the subscapularis or the supraspinatus tendon (≥ 6 mm) should be refixed as well. Massive anterosuperior rotator cuff tears should be treated immediately because of the high retraction tendency of the subscapularis tendon.