Massive Tear of the Rotator Cuff

Yang-Soo Kim; Hyo-Jin Lee

doi:10.4055/jkoa.2013.48.1.54

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Kim and Lee: Massive Tear of the Rotator Cuff

Instructional Course Lecture

Management of Massive Rotator Cuff Tear

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(1): 54-60.

Published online: 26 February 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.1.54

Massive Tear of the Rotator Cuff

Yang-Soo Kim, M.D., Ph.D., Hyo-Jin Lee, M.D.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to: Yang-Soo Kim, M.D., Ph.D. Department of Orthopedic Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, 222, Banpo-daero, Seocho-gu, Seoul 137-701, Korea. TEL: +82-2-2258-6117, FAX: +82-2-535-9834, kysoos@catholic.ac.kr

Received 15 January 2013 Revised 27 January 2013 Accepted 28 January 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Massive rotator cuff tear is defined by either a tear size of more than 5 cm or involvement of more than two rotator cuffs. In reality, among Asians, it is almost impossible to find a tear size larger than 5 cm and the latter definition preferred. Most massive rotator cuff tears are chronic and patients usually complain of gradual aggravation of pain or muscle weakness. Exact evaluation of past history along with an appropriate physical examination is necessary for the exact diagnosis and further treatment. As most massive rotator cuff tears are based on chronic factors, not only the tear site, but whole tendon quality may be poor, making anatomical reconstruction difficult. In addition to primary repair of the torn tendon, many other treatment options are available, such as physical therapy, biceps tenotomy/tenodesis, release of suprascapular nerve, repair with tissue augmentation, tendon transfer, or arthroplasty. These options should be selected carefully according to the symptoms.

Keywords: shoulder, rotator cuff, massive tear

Figures and Tables

Figure 1

The classification of supraspinatus muscle atrophy. Cited from the article of Warner et al. (Fig. 1) with permission.12)

Table 1

Hamada-Fukuda Radiographic Classification of Massive Rotator Curr Tears

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