title: Posterosuperior rotator cuff tears: classification, pattern recognition, and treatment.
abstract: The posterosuperior rotator cuff, composed of the supraspinatus and infraspinatus tendons, is the most common site for full-thickness rotator cuff tears and represents a significant source of shoulder disability worldwide. Recognition of and classification of full-thickness tear patterns are essential in order to optimize surgical treatment and to improve prognosis. Until recently, tear patterns have been described using one- or two-dimensional classification systems. Three-dimensional pattern recognition is critical to achieving the most successful outcome possible. For more complex patterns, a combination of side-to-side stitching, margin convergence, and interval slide techniques may be needed to achieve a tension-free tendon-bone repair. Biomechanical and anatomic evidence supports the use of linked double-row repairs for most full-thickness tears. Although double-row repairs seem to result in improved structural outcomes, clinical evidence has not shown differences in outcomes scores between single-row and double-row repairs. Single-row repair may be performed in partial-thickness, small full-thickness, or very massive, immobile tears, whereas double-row repair may be performed in most other cases.
authors: Peter J
authors: PJ
authors: Millett
authors: Ryan J
authors: RJ
authors: Warth
mesh_terms: D001182:Arthroscopy / Q000379:methods; D003952:Diagnostic Imaging; D019317:Evidence-Based Medicine; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques