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Current concepts on management of cuff tear
Akil Prabhakar1, Jeash Narayan Kanthalu Subramanian2, P Swathikaa1
1Department of Orthopaedics, Velammal Medical College and Research Institute, Velammal Village, Madurai-Tuticorin Ring Road, Anuppanadi, Tamil Nadu, 625009, India.
Journal of Clinical Orthopaedics and Trauma
|April 11, 2022
Summary
Rotator cuff tears are common shoulder injuries, often treated with rehabilitation. Surgical repair is indicated for failed rehabilitation or acute tears, with advancements like augmentation showing variable but promising results.
Area of Science:
- Orthopedics
- Sports Medicine
- Regenerative Medicine
Background:
- Rotator cuff tears are the most frequent shoulder pathology, with prevalence increasing after age 40.
- Tears can be asymptomatic, yet progression is a known consequence, ranging from partial to full-thickness with retraction.
- Diagnosis in younger individuals is uncommon, but incidence rises significantly with age, affecting 20-30% of those over 60.
Purpose of the Study:
- To review the current understanding and management strategies for rotator cuff tears.
- To discuss the indications for surgical intervention versus conservative treatment.
- To explore recent advancements in surgical augmentation for rotator cuff repair.
Main Methods:
- Systematic review of literature on rotator cuff tear diagnosis and treatment.
- Analysis of rehabilitation protocols, surgical indications, and techniques.
- Evaluation of outcomes for both conservative and surgical management, including augmented repairs.
Main Results:
- Rehabilitation is the primary treatment for partial tears and initial management for full-thickness tears.
- Surgical repair indications include failed conservative treatment, acute traumatic tears, and specific patient factors.
- Augmentation with growth factors (e.g., PRP) or scaffolds shows variable but potentially beneficial outcomes.
Conclusions:
- Rotator cuff tears present diverse features, necessitating tailored management plans.
- The primary goal of treatment is pain relief and functional restoration.
- Systematic rehabilitation is the first-line approach, with surgical intervention reserved for specific cases, emphasizing patient selection and technique for optimal outcomes.
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