AANA/ISAKOS Knee and Shoulder Arthroscopy Course-Online Didactics (April 2024)-Large and Retracted Rotator Cuff Tears

Large and Retracted Rotator Cuff Tears_ When and How to do Soft Tissue Releases

Video Transcription

Video Summary

Joe Toro from Ocean County Sports Medicine and Rutgers Medical School discusses large, retracted rotator cuff tears and the importance of soft tissue releases during repair. He explains that the capsule and cuff stay attached after a tendon tear, often causing tethering and necessitating releases for better tendon mobility. Not all large tears require releases, especially acute ones with mobile tendons. Releases involve detaching contracted capsules (superior, anterior, posterior) and addressing adhesions to enable low-tension repairs. He highlights different tear types (crescent, L-shaped) and techniques like anterior interval and double interval releases to improve tendon excursion. Repair choices depend on tendon quality and mobility, with single-row repair favored when tendon tissue is limited, though double-row is preferable when possible. For recurrent tears, comprehensive releases and ripstop suture techniques are used to reinforce repairs. Throughout, meticulous debridement and visualization from the bursal side are emphasized for successful tendon healing and tension reduction.

Keywords

rotator cuff tears

soft tissue releases

tendon mobility

single-row repair

ripstop suture technique