title: Management of massive and irreparable rotator cuff tears.
abstract: Massive rotator cuff tears pose a distinct clinical challenge for the orthopaedist. In this review, we will discuss the classification, diagnosis, and evaluation of massive rotator cuff tears before discussing various treatment options for this problem. Nonoperative treatment has had inconsistent results and proven unsuccessful for chronic symptoms while operative treatment including debridement and partial and complete repairs have had varying degrees of success. For rotator cuff tears that are deemed irreparable, treatment options are limited. The use of tendon transfers in younger patients to reconstruct rotator cuff function and restore shoulder kinematics can be useful in salvaging this difficult problem.
authors.affiliation: ProHEALTH Care Associates, Lake Success, NY, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Neri
authors.forename: Keith W
authors.initials: KW
authors.lastname: Chan
authors.forename: Young W
authors.initials: YW
authors.lastname: Kwon
mesh_terms: D003646:Debridement / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000628:therapy; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome