Editorial Commentary: In Contrast to Chronic, Degenerative Rotator Cuff Tears, the Critical Shoulder Angle in...

There are 2 distinct types of rotator cuff tears. The first is a chronic, degenerative tear, which is more common. The second is an acute traumatic tear. (There is also likely a third, hybrid type consisting of an acute-on-chronic tear) Traumatic tears result in acute dysfunction with weakness and loss of range of motion. Traumatic tears are large to massive in size and have higher degrees of subscapularis involvement. If a patient has an acute cuff tear, the surgeon should fix it. The surgeon should not take the time to measure the critical shoulder angle (CSA) or plan an acromioplasty but should just fix the tear-the sooner, the better. The CSA has been emerging as a concept in trying to figure out the pathogenesis and treatment of degenerative tears. But, when it comes to traumatic tears, the CSA can be ignored. It likely does not have a role in the causation or treatment of traumatic rotator cuff tears.