[Degenerative lesions of the rotator cuff of the shoulder. Current status of the surgical treatment].
With age there is a progressive deterioration in the capsulo-tendinous cuff of the shoulder: When rotator cuff lesions are limited (in general to the supra-spinatus), the cuff remains continent and functional, thereby ensuring good centering of the humeral head. At this stage antero-superior arthrolysis may be indicated for cases of failure of conservative treatment. When there is a large degree of capsulo-tendinous perforation (affecting posteriorly the supra-spinatus), the cuff no longer ensures centering of the humeral head and friction with the lip of the acromion progresses until an eccentric arthrosis of the shoulder develops. The surgical treatment of choice is then a deltoid flap procedure which fills in the loss of substance in the cuff and centers the humeral head. The course of eccentric arthrosis of the shoulder itself involves three stages: --stage I: limited to acromio-humeral friction where a deltoid flap is indicated as treatment; --stage II: extension or arthrosis to the gleno-humeral level, but without formation of a neoglenoid, where an unrestricted gleno-humeral prosthesis, centered by a combined flap procedure, is in our opinion the best surgical solution; --stage III: where the formation of an eccentric supero-medial neoglenoid produces very unpredictable functional results after arthroplastic procedures.
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D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012421:Rupture; D012785:Shoulder Joint; D013577:Syndrome
Lésions dégénératives de la coiffe des rotateurs de l'épaule. Etat actuel du traitement chirurgical.