Factors Influencing the Reparability and Healing Rates of Rotator Cuff Tears
- PDF / 4,035,269 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 202 Views
SURGICAL MANAGEMENT OF MASSIVE IRREPARABLE CUFF TEARS (J SANCHEZ-SOTELO, SECTION EDITOR)
Factors Influencing the Reparability and Healing Rates of Rotator Cuff Tears Andrew R. Jensen 1 & Adam J. Taylor 2 & Joaquin Sanchez-Sotelo 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of the Review To discuss tear- and patient-related factors that influence the healing potential of rotator cuff tears and to clarify the terminology surrounding this topic. Recent Findings Over the last few years, further insight has been gained regarding rotator cuff tear features that are associated with poor healing rates after rotator cuff repair. Some of these features have been incorporated in prediction models developed to accurately predict rotator cuff healing rates utilizing preoperative risk factors weighted by importance. Summary Rotator cuff tears may be considered functionally irreparable based on their size, chronicity, absence of adequate tendon length, atrophy, and fatty infiltration. Furthermore, advanced age, use of tobacco products, diabetes, and other patientrelated factors may impair tendon healing. Careful analysis and discussion of all these factors with patients is essential to determine if surgical repair of a rotator cuff tear should be recommended, or if it is best to proceed with one of the several salvage procedures reviewed in this topical collection, including augmentation of the repair, superior capsular reconstruction, tendon transfers, and other. Keywords Rotator cuff . Rotator cuff repair . Re-tear . Non-healing . Irreparable . Factors
Introduction The ultimate goal of rotator cuff repair surgery is to eliminate pain and restore function. Healing of the rotator cuff tendons after rotator cuff repair has been shown to best achieve these goals, with worse functional outcomes seen in those patients This article is part of the Topical Collection on Surgical Management of Massive Irreparable Cuff Tears * Joaquin Sanchez-Sotelo [email protected] Andrew R. Jensen [email protected] Adam J. Taylor [email protected] 1
Department of Orthopaedic Surgery, University of California, Los Angeles, CA 90403, USA
2
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA
3
Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA 90502, USA
whose rotator cuff tears do not heal [1, 2]. Therefore, most would agree that maximizing the likelihood of rotator cuff healing is desirable in order to optimize patient outcomes [3]. Unfortunately, a substantial percentage of rotator cuff repairs do not result in tendon healing [4]. A recent meta-analysis reported a mean rotator cuff repair surgery non-healing rate of 26.6% [5]. Tendon healing rates have been found to be highly dependent upon multiple tear- and patient-related factors, and, accordingly, a great deal of research has been performed to better elucidate and understand the relative contributions of these factors to successful healing [6]. Broadly speaki
Data Loading...
