title: Massive rotator cuff tears: arthroscopy to arthroplasty.
abstract: The understanding of rotator cuff disease has increased exponentially since Codman drew attention to this pathology in the early 1900s. Although challenging, the surgical treatment of massive rotator cuff tears is rational, with treatment decisions based on physical examination, imaging, biologic, and patient factors. Arthroscopy can be used to treat ancillary pain generators, débride necrotic tissue, and possibly restore balance to the force couples about the shoulder. Tendon transfers may be effective in restoring functional strength to irreparable, ineffectual muscle units. Arthroplasty is both a primary treatment and a salvage option.
authors.affiliation: Kaiser Permanente Medical Center, San Diego, California, USA.
authors.forename: Anshu
authors.initials: A
authors.lastname: Singh
authors.forename: Andrew
authors.initials: A
authors.lastname: Jawa
authors.forename: Monica
authors.initials: M
authors.lastname: Morman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sanofsky
authors.forename: Laurence
authors.initials: L
authors.lastname: Higgins
mesh_terms: D001178:Arthroplasty; D001182:Arthroscopy; D006801:Humans; D007595:Joint Prosthesis; D018579:Patient Selection; D011474:Prosthesis Design; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013709:Tendon Transfer; D016896:Treatment Outcome