AANA25 Shoulder Access Pass-GENERAL SESSION: Massive Rotator Cuff Tears (Main Stage)

Video Transcription

Video Summary

The Massive Rotator Cuff Tears session covered advocacy in medical practice management and detailed surgical techniques and outcomes for massive rotator cuff tear treatments. Patrick Joyner emphasized the need for physicians to engage more in advocacy and business practices to counter declining reimbursements and increasing operating costs. The session then presented three studies: one comparing five-year outcomes of superior capsule reconstruction (SCR) versus bridging grafts in irreparable tears found no significant difference in clinical results; another introduced biologic tuberoplasty using dermal allografts as a simpler, effective procedure preventing bone-to-bone contact with promising early results; and a third examined scope-assisted lower trap tendon transfers, demonstrating improved short-term outcomes for irreparable tears regardless of subscapularis tear status.<br /><br />A debate followed on managing a hypothetical 52-year-old with a massive recurrent cuff tear. Dr. Catherine Burns advocated repair with dermal augment for joint preservation, Dr. Eric Wagner favored partial cuff repair plus lower trapezius transfer for muscle replacement, and Dr. Mike Freehill supported reverse shoulder arthroplasty for advanced cases. A clinical case of a 69-year-old active woman with recurrent tear elicited discussion favoring initial non-operative treatment transitioning to surgical repair with augmentation over reverse arthroplasty due to patient activity level and soft-tissue quality. Overall, the session highlighted evolving techniques balancing structural repair, augmentation, and joint replacement tailored to patient specifics in managing massive rotator cuff tears.

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Keywords

massive rotator cuff tears

advocacy in medical practice

surgical techniques

superior capsule reconstruction

bridging grafts

biologic tuberoplasty

dermal allografts

lower trapezius tendon transfer

reverse shoulder arthroplasty