[Irreparable rotator cuff tear-reverse shoulder arthroplasty and alternative procedures].

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Irreparable rotator cuff tears present a significant clinical challenge.
• Tendon retraction and muscle degeneration preclude direct reconstruction.
• Patients experience pain and pseudoparalysis, impacting quality of life.

Purpose of the Study:

• To review current treatment options for irreparable rotator cuff tears.
• To present an evidence-based treatment algorithm for clinical decision-making.
• To compare outcomes of various surgical and non-surgical interventions.

Main Methods:

• Literature review of treatment strategies for irreparable rotator cuff tears.
• Analysis of outcomes for joint-preserving techniques, prosthetics, and conservative management.
• Development of a treatment algorithm based on patient age, frailty, and tear characteristics.

Main Results:

• Inverse shoulder prosthesis is effective for older patients.
• Joint-preserving techniques are recommended for younger patients.
• Minimally invasive arthroscopy offers pain relief but limited functional restoration; grafts or muscle transfer may be needed.

Conclusions:

• A tailored treatment algorithm can guide management of irreparable rotator cuff tears.
• Treatment choice depends on patient-specific factors, including age and suitability for joint replacement.
• Further research into regenerative and reconstructive techniques is warranted.