title: Challenges and Controversies in Treating Massive Rotator Cuff Tears.
abstract: Massive rotator cuff tears present several challenges for orthopaedic surgeons. Many rotator cuff tears can be repaired; however, some chronic rotator cuff tears require advanced reconstructive techniques. Repair, if possible, is the optimal treatment for rotator cuff tears. In general, muscle transfers are an option for patients younger than 60 years who do not have pseudoparalysis. Arthroplasty is an option for older patients who have concomitant arthritis and for patients who have pseudoparalysis. Biologic augmentation in the setting of rotator cuff tears continues to evolve, and the application of biologic products should be guided by sound evidence and cost-benefit considerations.
authors.affiliation: Orthopaedic Surgeon, The San Antonio Orthopaedic Group, San Antonio, Texas.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Burkhart
authors.forename: Eric T
authors.initials: ET
authors.lastname: Ricchetti
authors.forename: William N
authors.initials: WN
authors.lastname: Levine
authors.forename: Leesa M
authors.initials: LM
authors.lastname: Galatz
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D018579:Patient Selection; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013709:Tendon Transfer / Q000379:methods*; D054457:Tissue Scaffolds; D015599:Trauma Severity Indices; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials