SEARCH · PubMed Health

Results for “Rotator Cuff”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources

PubMedDate not supplied

Infection after mini-open rotator cuff repair.

A consecutive case series from 2 institutions of patients with postoperative wound infections after mini-open rotator cuff repair was reviewed. Between 1991 and 2000, 360 patients underwent mini-open rotator cuff repair after arthroscopic subacromial decompression. Seven patients had postoperative infection develop (1.9%). All patients were men, with a mean age of 55 years (range, 40-64 years). Treatment included serial irrigation and debridement, long-term intravenous antibiotics, and revision rotator cuff repair. Mean follow-up after definitive treatment was 32 months (range, 12-57 months). Propionibacter acnes was present in 6 of 7 patients (86%) with infections. The initial rotator cuff repair was disrupted in 4 shoulders and intact in 3. A revision rotator cuff repair was performed at the final irrigation and debridement in all 4 shoulders. Results were 100% satisfactory. The mean American Shoulder and Elbow Surgeons pain score improved from 7 (range, 6-9) preoperatively to 1 (range, 0-2). The mean final score was 95. Because these infections were noted to occur only in arthroscopically assisted rotator cuff repairs, a second preparation and draping were introduced as routine protocol. No postoperative infections have occurred in the ensuing 200 mini-open rotator cuff repairs.

Adult↗

PubMed1993

Shoulder strength with rotator cuff tears. Pre- and postoperative analysis.

Twenty-five patients with rotator cuff tears had bilateral isokinetic shoulder strength evaluations after a pain-relieving subacromial lidocaine injection. Shoulder strength testing was repeated at six months and again at 12 months after rotator cuff surgery. Strength was recorded as a ratio of peak torques comparing the operative with the nonoperative shoulder. Preoperative strength averaged 37%, 36%, and 33% for abduction, external rotation, and forward flexion. Six-month postoperative strength increased to 68%, 76%, and 66% for abduction, external rotation, and forward flexion, respectively. Twelve-month postoperative strength increased to 104%, 142%, and 97% for abduction, external rotation, and forward flexion. Shoulders with rotator cuff tears demonstrate major objective signs of weakness. Shoulder pain obscures objective evaluation of weakness. Preoperative strength can be accurately measured after subacromial lidocaine injection. Shoulder strength is significantly improved by rotator cuff repair.

Biomechanical Phenomena↗

PubMedDate not supplied

A biomechanical analysis of rotator cuff deficiency in a cadaveric model.

We conducted this cadaveric study to define a biomechanical rationale for rotator cuff function in several deficiency states. A dynamic shoulder testing apparatus was used to examine change in middle deltoid muscle force and humeral translation associated with simulated rotator cuff tendon paralyses and various sizes of rotator cuff tears. Supraspinatus paralysis resulted in a significant increase (101%) in the middle deltoid force required to initiate abduction. This increase diminished to only 12% for full glenohumeral abduction. The glenohumeral joint maintained ball-and-socket kinematics during glenohumeral abduction in the scapular plane with an intact rotator cuff. No significant alterations in humeral translation occurred with a simulated supraspinatus paralysis, nor with 1-, 3-, and 5-cm rotator cuff tears, provided the infraspinatus tendon was functional. Global tears resulted in an inability to elevate beyond 25 degrees of glenohumeral abduction despite a threefold increase in middle deltoid force. These results validated the importance of the supraspinatus tendon during the initiation of abduction. Glenohumeral joint motion was not affected when the "transverse force couple" (subscapularis, infraspinatus, and teres minor tendons) remained intact. Significant changes in glenohumeral joint motion occurred only if paralysis or anatomic deficiency violated this force couple. Finally, this model confirmed that rotator cuff disease treatment must address function in addition to anatomy.

Aged↗

PubMed2002

LactoSorb plates for rotator cuff repair.

PURPOSE: We present our preliminary studies using LactoSorb plates (Lorenz/Biomet, Warsaw, IN) for rotator cuff repair in humans. The use and application of this plate are described as an adjunct to prevent hole migration in trough-tunnel repairs of rotator cuff tears. METHODS: Fifty patients with rotator cuff tears documented by magnetic resonance imaging underwent arthroscopic subacromial decompression followed by a mini-open repair of the rotator cuff. Tears were repaired using a trough and tunnel technique, horizontal mattress sutures, and a standard LactoSorb plate. Follow-up was obtained on 45 patients, 26 male and 19 female, with an average age of 61.6 years. The patients were followed-up and evaluated at 5 days, 1 month, 3 months, 6 months, and a minimum of 1 year postoperatively. All surgeries were performed by the same surgeon and followed a similar rehabilitation protocol. RESULTS: There were 89% excellent results, 9% good results, and 2% fair results. There were no poor results. No significant swelling, tenderness, or erythema was noted at the operative site, and there were no infections. Postoperative radiographs at 3, 6, and 12 months did not show any bone erosion. No repeat surgical procedures were necessary. CONCLUSION: The results of our study support the use of LactoSorb bioabsorbable plates in the repair of rotator cuff tears to prevent hole migration and potentially poor results or failures of repairs. The LactoSorb plate appears to maintain its strength during the healing period of the repair and does not elicit any clinically noticeable inflammatory process.

Absorbable Implants↗

PubMed2004

2D SPLASH: a new method to determine the fatty infiltration of the rotator cuff muscles.

The objective of this paper is to quantify the fatty degeneration (infiltration) of rotator cuff muscles with a new spectroscopic FLASH (SPLASH) sequence. Before planned surgery (reconstruction or muscle transfer), 20 patients (13 men, 7 women; 35-75 years) with different stages of rotator cuff disease underwent an MR examination in a 1.5-T unit. The protocol consists of imaging sequences and a newly implemented SPLASH, which allows an exact quantification of the fat/water ratio with a high spatial resolution in an arbitrarily shaped region of interest (ROI). The percentages of fat in the rotator cuff muscles were determined. To determine statistically significant differences between the different stages of rotator cuff tear, a Kruskal-Wallis H test was used. Fatty infiltration of the supraspinatus muscle was correlated with cross-sectional area (CSA) measures (Bravais-Pearson). We found significant differences between different stages of rotator cuff disease, the fatty infiltration and the volume loss (determined by the occupation ratio) of the supraspinatus muscle. With the increasing extent of rotator cuff disease, fatty infiltration increases significantly, as does the volume loss of the supraspinatus muscle. Comparing fatty infiltration and the occupation ratio individually, there was only a moderate inverse correlation between fatty infiltration and the occupation ratio, with considerable variation of data. Fatty infiltration of the infraspinatus muscle occurred when the infraspinatus tendon was involved to a lesser extent. The SPLASH sequence allows exact quantification of fatty infiltration in an arbitrarily shaped ROI. The extent of atrophy and fatty infiltration correlates with the size of the tear. Atrophy and fatty infiltration correlate only moderately and should be evaluated separately.

Adipose Tissue↗

PubMedDate not supplied

Repair of massive rotator cuff tears in patients older than 70 years.

Major ruptures of the rotator cuff are common in elderly patients, and their management has been a challenge for orthopaedic surgeons. This study was undertaken to evaluate the results obtained in patients older than 70 years who were treated with open surgical repair for massive ruptures of the rotator cuff tendons and to correlate the functional outcomes with the quality of the repairs. Between January 1991 and November 1994, 69 patients older than 70 years of age underwent rotator cuff repairs of massive tears with a minimum follow-up of 2 years (mean of 3 years). These patients were evaluated before and after surgery with the University of California at Los Angeles score. The mean age was 75 years (range 70 to 90 years), and female sex and right shoulder were predominant. A good bone-tendon repair was achieved in 55 patients, a fair bone-tendon repair in 5 patients, a poor bone tendon-repair in 8 patients, and 1 patient had no repair. The mean University of California at Los Angeles rating score before surgery was 9.4 points, and the mean postoperative score at final follow-up was 30.9 points, with an average improvement of 21.5 points (P = .0001). Satisfactory results were achieved in 78.2% of the patients (University of California at Los Angeles score equal or over 28). The patients' clinical results and postoperative arthrograms are evaluated with regard to the quality of cuff repair. Painful massive rotator cuff tears can be repaired in patients older than 70 years with satisfactory results.

Age Factors↗

PubMedDate not supplied

US of the shoulder: non-rotator cuff disorders.

The most common indication for shoulder ultrasonography (US) is the diagnosis of rotator cuff disease. However, there is a spectrum of non-rotator cuff abnormalities that are amenable to US examination, including instability of the biceps tendon, glenohumeral joint, and acromioclavicular joint; arthropathies and bursites (inflammatory diseases, degenerative and infiltrative disorders, infections); nerve entrapment syndromes; and space-occupying lesions. Many of these conditions may be overlooked clinically or can even mimic rotator cuff tears, and US can help redirect the diagnosis if a complete shoulder examination rather than a simple rotator cuff assessment is performed. In addition, US can be remarkably helpful in guiding either needle aspiration procedures or local injection therapy in patients with synovial processes. Although radiography, magnetic resonance (MR) imaging, and computed tomographic and MR arthrography are effective modalities for the evaluation of non-rotator cuff disorders, US is both less costly and less invasive and will likely be used more frequently in this setting as experience increases. Once adequate radiographs have been obtained to exclude apparent bone disorders, high-resolution US should be the first-line imaging modality in the assessment of non-rotator cuff disorders of the shoulder, assuming the study is performed with high-end equipment by an experienced examiner.

Arthritis↗

PubMed1997

[Effect of the rotator cuff condition on the results of shoulder arthroplasty].

PURPOSE OF THE STUDY: The purpose of this report was to study the repercussions of rotator cuff condition on unconstrained shoulder arthroplasty results. METHODS: Between 1986 and 1993, 40 unconstrained shoulder prostheses were performed (24 total and 16 hemiarthroplasties). At the time of the operation, rotator cuff condition was reported to be normal in 15 shoulders, atrophic in 10, scarred in 3, torn in 12. Clinical and radiographical results were analyzed and supplemented with a rotator cuff echography. Postoperative follow-up averaged 42.25 months (12 to 97 months). RESULTS: When the rotator cuff was intact at the time of operation, clinical results were the best at the time of review. Constant score, overall mobility, forward elevation, external rotation with the elbow along the side were better for intact than for atrophic, scarred or torn rotator cuffs (p < 0.01). Ruptures repaired by local tissue transfer or trapezo deltoidal flap substitution (3 cases) gave satisfactory results, whereas two dacron cuff prostheses failed. In the non repaired ruptures (7 cases), arthroplasty resulted in 3/4 fair or poor results. At the time of review, the total incidence of postoperative rotator cuff tears was high (12 cases), functional repercussions were variable. Among the 15 rotator cuff tears observed at the time of the review, the long head of the biceps was present and in place in 9 cases and ruptured in 6 cases. In these latter cases, Constant score (p < 0.01), the forward elevation (p < 0.01), external rotation with elbow along side (p < 0.05) and overall mobility (p < 0.05) were worse; moreover, humeral head superior migration was greater (p < 0.01). DISCUSSION: Our study confirms the superiority of clinical results when the cuff was intact at the time of the operation. The repair of rotator cuff tears seems to be justified. When the rupture has not been repaired, clinical results were fair or poor in 5 cases out of 7, the initial rupture spread to the other tendons in 3 cases out of 7. Secondary ruptures were frequent (12 cases). No predictive factor was identified, but an overlapping of the greater tuberosity appears to be detrimental. Among rotator cuff tears present at the time of review, long head of the biceps rupture jeopardized clinical results and was associated with a proximal migration of the humeral head which was significantly more severe than with an intact non displaced long head of the biceps. CONCLUSION: During unconstrained shoulder prosthesis implantation, it is therefore recommend to systematically repair any associated rotator cuff rupture, in order to avoid any greater tuberosity overlap relative to the prosthetic head and to preserve the long head of the biceps tendon which limits upward migration of the humeral head and improves prosthetic kinetics.

Adult↗

PubMedDate not supplied

MR imaging of rotator cuff tears: is there a diagnostic benefit of shoulder exercise prior to imaging.

The purpose of this study was to determine if shoulder exercise prior to MR imaging accentuates findings related to rotator cuff tears. In 32 consecutive patients undergoing MR imaging to evaluate the rotator cuff, after routine MR examination, the joint was moved by active or passive exercise (circumduction, including abduction, if possible) in an attempt to redistribute any joint fluid. The exercise was performed according to pain tolerance and for no longer than 4 minutes. The coronal oblique fast spin-echo T2-weighted images of these patients performed before exercise were reviewed by consensus agreement of two musculoskeletal radiologists who were blinded to clinical information. The appearance of the rotator cuff tendons and the distribution of fluid in the glenohumeral joint were determined. The identical postexercise MR images then were placed alongside the corresponding preexercise MR images, and a direct comparison of findings was made with regard to any change in the appearance of the rotator cuff or joint fluid by consensus opinion of the same two radiologists. Five patients (five shoulders) could not perform exercise because of pain. In the remaining 27 patients (27 shoulders), changes in the location of joint fluid were seen when the preexercise and postexercise images were reviewed together, the diagnosis of partial rotator cuff tear (n = 8) was changed to normal in two cases, and the diagnosis of partial tear was made with more confidence in one case. The diagnoses of normal rotator cuff (n = 16) and complete rotator cuff tear (n = 3) were unchanged. Eight patients had arthroscopy; in each of these, the preexercise and postexercise images showed similar results, and proved to be correct surgically (six normal, one partial rotator cuff tear, and one complete rotator cuff tear). Although postexercise MR images show changes in the distribution of joint fluid when compared to preexercise images, the diagnostic benefits of the postexercise images in the analysis of the rotator cuff appear to be limited.

Exercise↗

PubMed2003

Chronic rotator cuff injury and repair model in sheep.

BACKGROUND: Most rotator cuff surgery is performed on chronic tears. As there is no animal model in which to examine the physiology of muscle and tendon injury and repair in this setting, we developed a chronic rotator cuff injury model in sheep. METHODS: The infraspinatus tendon was released in thirty-six female sheep. Biopsy specimens were obtained from the muscle and were analyzed for fat content. The force generated by the muscle with supramaximal stimulation was recorded intraoperatively. A control group (twelve sheep) underwent an immediate tendon repair. In the remaining twenty-four sheep, the tendon was wrapped in a dura substitute to prevent scarring and was repaired at six weeks (eight sheep) and eighteen weeks (sixteen sheep) after release. In the immediate repair group, four animals were killed at six weeks; four, at twelve weeks; and four, at twenty weeks. In the six-week delayed repair group, four animals were killed at twelve weeks and four were killed at twenty weeks after the repair. In the eighteen-week delayed repair group, eight animals were killed at twelve weeks; four, at twenty weeks; and four, at thirty weeks after the repair. Muscle biopsies and testing were repeated prior to killing of the animals. RESULTS: The average force of muscle contraction decreased 3.6 lb (1.6 kg) by six weeks after the injury and 3.9 lb (1.8 kg) by eighteen weeks after the injury. After the repair, the force of contraction in the six-week group improved by 0.8 lb (0.4 kg) at twelve weeks postoperatively and by 1.3 lb (0.6 kg) at twenty weeks postoperatively. In contrast, no improvement occurred in the eighteen-week group until thirty weeks after the repair, at which time a 0.9-lb (0.4-kg) improvement was noted. There was a twelvefold increase in intramuscular fat concentration; this lipid infiltration was partially reversed after the tendon repair. Isolated tendon samples demonstrated an increase in the modulus of elasticity after chronic detachment that partially corrected after the tendon repair in the earlier (six-week) repair group. CONCLUSIONS: We found that earlier repair of the tendon results in a more rapid recovery of both muscle function and tendon elasticity compared with a more delayed repair. We concluded that there may be a "point of no return" in rotator cuff injury after which the elasticity of the muscle-tendon unit does not return to normal.

Animals↗

PubMed2026

Application of musculoskeletal ultrasound in postoperative rehabilitation assessment and monitoring after rotator cuff repair: A systematic review.

BACKGROUND: The development of rehabilitation protocols after rotator cuff repair has long lacked objective benchmarks. Traditional time‑based regimens are limited by considerable inter‑individual variability and an increased risk of re‑tear. Musculoskeletal ultrasound allows dynamic assessment of tendon healing and muscle morphology, yet evidence for directly linking its use to rehabilitation decisions remains scarce. OBJECTIVE: To systematically synthesize the evidence on the use of musculoskeletal ultrasound monitoring to inform rehabilitation decision‑making after rotator cuff repair. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines, we searched PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data from January 2020 to April 2026. Original studies were included if they involved patients who had undergone rotator cuff repair, used musculoskeletal ultrasound (including gray‑scale ultrasound, elastography, etc.) to evaluate the rotator cuff tendons or shoulder muscles, and reported at least one parameter related to rehabilitation decision-making or functional outcomes. RESULTS: Eleven studies were included. Shear wave velocity (SWV), cross‑sectional area (CSA), and echo intensity (EI) were the most frequently reported ultrasound parameters. Available evidence indicated that SWV increased progressively after surgery, with an overall increase of approximately 22% to 25% from one week to 12 months postoperatively. This dynamic trajectory may serve as a reference baseline for judging rehabilitation progress. An abnormally elevated SWV in the early postoperative period was associated with an increased risk of re‑tear, suggesting that a more conservative rehabilitation strategy should be adopted. Tendon stiffness measured at 12 weeks after surgery independently predicted long‑term return to sport. Regarding muscle parameters, changes in CSA and EI were positively correlated with shoulder function scores, and the combination of these two parameters effectively identified patients with rehabilitation bottlenecks. CONCLUSION: Musculoskeletal ultrasound parameters are associated with the initiation of active movement, adjustment of exercise load, prediction of return‑to‑sport prognosis, and identification of retear risk. Among these, SWV shows particular promise as an objective monitoring parameter for supporting rehabilitation assessment after rotator cuff repair. Future randomized controlled trials are needed to determine whether ultrasound-informed assessment can improve rehabilitation outcomes compared with traditional time-based regimens, and to establish standardized measurement protocols and clinically applicable reference values. Key findings of this review are summarized in S1 File.

Humans↗

PubMed1996

Evaluation of post-exercise magnetic resonance images of the rotator cuff.

OBJECTIVE: To examine the effect of strenuous exercise on the magnetic resonance imaging (MRI) characteristics of the rotator cuff tendon. A second objective was to define an optimal time to image the rotator cuff and possibly eliminate exercise-induced false positives. DESIGN AND PATIENTS: Five male subjects from 24 to 38 years old with normal rotator cuffs by history, physical examination, and screening MRI underwent a rotator cuff exercise session on the Biodex System 2 (Biodex, Shirley, New York). The exercise sessions were followed by sequential MRI scans of the exercised shoulder. These were performed immediately and at 8 h and 24 h after exercise. RESULTS AND CONCLUSIONS: The rotator cuff tendon and subacromial-subdeltoid bursal signal remained unchanged from the pre-exercise through the 24-h post-exercise scans. The rotator cuff muscle signal was increased in five of five subjects on the immediate post-exercise fat-suppressed T2-weighted images. This signal returned to baseline by the 8-h scan. Positive findings of rotator cuff pathology on MRI after strenuous athletic activity should not be discounted as normal exercise-induced changes. Also, diagnostic MRI scanning may take place after a practice session without an increased risk of false positives.

Adult↗

PubMed2005

Prevention of shoulder stiffness after rotator cuff repair.

UNLABELLED: Predisposing factors for shoulder stiffness after rotator cuff repair have yet to be determined. The potential for recovery of range of motion and amelioration of pain in patients with this complication also remains unclear. Accordingly, data collected prospectively for 209 patients with a primary rotator cuff repair were retrospectively reviewed. Two groups, Group A (early motion recovery) and Group B (shoulder stiffness), were selected according to passive shoulder range of motion outcomes 6 weeks postoperatively. Both groups were compared for 10 descriptive and clinical characteristics, and for passive range of motion, muscle force, and functional outcomes obtained 0, 6, 12, 24, and 76 weeks postoperatively. Of the potential prognostic factors examined, restriction of range of motion for the preoperative hand behind the back best predicted shoulder stiffness at 6 weeks postoperatively. For patients with postoperative shoulder stiffness, pain had subsided by 24 weeks postoperatively, whereas range of motion steadily improved between 6 weeks and 76 weeks postoperatively. Results of the current study support a predictive role for restriction of range of motion for the preoperative hand behind the back, and affirms the potential for nearly complete recovery of range of motion and amelioration of pain in patients who have shoulder stiffness after rotator cuff repair. LEVEL OF EVIDENCE: Prognostic study, Level I-1 (prospective study).

Adult↗

PubMed2000

[Three-dimensional ultrasound evaluation of the rotator cuff. Preliminary results of clinical application].

AIM: Accurate sonographic diagnosis of rotator cuff lesions mainly depends on image quality and on the experience of the examiner. The present study was performed to determine whether the use of three dimensional (3D) sonography further increases the diagnostic yield of ultrasound examinations. METHOD: In a prospective study 25 patients who later underwent shoulder surgery of the rotator cuff were examined pre-operatively by ultrasound with two and three dimensional ultrasound. RESULTS: With three dimensional ultrasound rotator cuff lesions were more often correctly diagnosed (sensitivity of 100%) than with conventional 2D sonography (sensitivity of 91.7%). Specificity with both methods was 84.6% predictive value 92% and 88% respectively. In partial thickness tears, false-negative results were twice as common with 2D imaging. CONCLUSION: Although our results are preliminary and have to be verified in a larger study, three dimensional ultrasound appears to facilitate diagnosing of rotator cuff lesions and partial thickness tears, in particular.

Female↗

PubMed2005

The effect of rotator cuff tear size on shoulder strength and range of motion.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To determine the effect of rotator cuff tear size on shoulder strength and range of motion. BACKGROUND: Patients with rotator cuff pathology typically present with weakness and motion loss in various motions. The extent to which the presence of a rotator cuff tear and the size of the tear affect strength and range of motion is not well understood. METHODS AND MEASURES: Sixty-one patients scheduled for surgery, with a diagnosis of a rotator cuff tear and/or subacromial impingement, underwent examination for shoulder pain, function, range of motion, and strength. The extent of rotator cuff pathology was documented during subsequent surgery (presence of tear, tear size, tear thickness). RESULTS: There were 10 massive tears, 15 large tears, 13 medium tears, 12 small tears, and 11 rotator cuffs without a tear. Patients had marked weakness in abduction strength at 90 degrees and 10 degrees of abduction, in external rotation strength at 90 degrees, and in the "full can test" (all, P<.0001). Marked range of motion losses in shoulder flexion and external rotation at 0 degrees and 90 degrees abduction (all, P<.001) were also observed. Abduction strength deficit at 10 degrees was affected by rotator cuff tear size (P<.0001). Twenty of 25 patients with large or massive tears had deficits greater than 50%, compared with only 1 of 11 patients with no tear, 2 of 12 patients with a small tear, and 5 of 13 patients with a medium tear (P<.0001). Other strength and range of motion deficits or indices of pain and function were unaffected by tear size. CONCLUSIONS: Weakness of greater than 50% relative to the contralateral side in shoulder abduction at 10 degrees of abduction was indicative of a large or massive rotator cuff tear.

Adult↗

PubMed2003

Mechanical properties of the rotator cuff: response to cyclic loading at varying abduction angles.

The rotator cuff is loaded under static as well as dynamic conditions. Whilst the static properties of the rotator cuff muscle-tendon junctions have been reported, the dynamic mechanical behaviour has not. This study reports the dynamic mechanical properties with varying abduction angles in a human cadaver rotator cuff. No significant effect was found with varying the angle of testing or in the presence of a tear in the tendon. The supraspinatus was found to be the stiffest of the rotator cuff tendons followed by the subscapularis and infraspinatus.

Adult↗

PubMedDate not supplied

Anatomy and dimensions of rotator cuff insertions.

The purpose of this study was to devise and implement an accurate and reproducible method of measuring the area and dimensions of the rotator cuff tendon insertions and their distance from the articular surface. Twenty fresh-frozen cadaveric upper-extremity specimens were divided into 2 groups of 10. In group 1 the specimens were dissected, leaving only the most distal rotator cuff tendons attached to the humerus. The periphery of the insertion onto the greater tuberosity was marked at 3-mm intervals. The specimens were then mounted onto a custom jig, and the insertion was mapped by a 3-space digitizer. In group 2 the specimens were prepared by removing all tissues except the rotator cuff muscles and tendons and the joint capsule. The interval between the muscles of the rotator cuff was identified and marked. The rotator cuff muscles and tendons were then removed, leaving only the most distal tendons attached to the tuberosities. The periphery of the individual cuff insertions was then marked as in group 1 and mapped in the same fashion. The articular margin also was marked at similar intervals and mapped with the same technique. The area of insertion of the 3 tendons on the greater tuberosity averaged 6.24 cm(2) (SD, 2.04 cm(2)) in group 1. The mean minimum transverse dimension across the cuff insertion occurred in the mid portion of the supraspinatus, with a mean distance of 14.7 mm (SD, 3.22 mm). In group 2 the mean area of insertion of the supraspinatus was 1.55 cm(2) (range, 0.68-2.64 cm(2); SD, 0.66 cm(2)) and the mean area of insertion for the infraspinatus was 1.76 cm(2) (range, 1.23-2.53 cm(2); SD, 0.40 cm(2)). The distance from the articular margin to the most medial rotator cuff fibers was less than 1 mm along the anterior-most 2.1 cm of the cuff insertion onto the greater tuberosity. No correlation could be made between humeral head dimension and the dimensions of the rotator cuff insertions. The mean minimum medial-to-lateral distance across the rotator cuff insertion was sizeable, at 14.7 mm. This represents the minimum possible distance, as the mathematical calculation to determine the dimensions used a perpendicular measurement. The rotator cuff inserts very closely to the articular margin along the anterior 2.1 cm of the greater tuberosity. These anatomic measurements may be useful in evaluating and reattaching the rotator cuff to the humerus.

Aged↗

PubMed2001

Arthroscopic rotator cuff repair: transition from mini-open to all-arthroscopic.

Rotator cuff repair is one of the most common surgical procedures done in the shoulder. Traditionally, repair has required an open incision with release of a portion of the deltoid from the acromion. In the past decade, an arthroscopically-assisted, mini-open approach has gained popularity. This has been facilitated by advances in the use of arthroscopy. This trend toward a more minimally invasive approach has continued as arthroscopic techniques continue to improve and advance. An all-arthroscopic approach recently has been used for rotator cuff repairs. The arthroscopic approach offers several advantages including smaller incisions, easy access to the glenohumeral joint for treatment of intraarticular diseases, less soft tissue dissection, and less potential harm to the deltoid. The purpose of the current study is to discuss recent advances in arthroscopic and mini-open rotator cuff repair techniques and to highlight the technical aspects of the mini-open procedures that are important in making the transition to an allarthroscopic rotator cuff repair.

Arthroscopy↗