Irreparable Massive Rotator Cuff Tear (AANA20)-My Patient Has an Irreparable Massive Rotator Cuff Tear_ When Should I Use a Soft Tissue Reconstruction, When Should I Use an Arthroplasty, and How do I Get it Right

My Patient Has an Irreparable Massive Rotator Cuff Tear_ When Should I Use a Soft Tissue Reconstruction, When Should I Use an Arthroplasty, and How do I Get it Right_-Dr. Michael H. Amini

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Video Summary

Dr. Michael Lamini from the Core Institute provides a comprehensive lecture on managing irreparable massive rotator cuff tears, focusing on when to opt for soft tissue reconstruction versus arthroplasty. Key predictors of irreparability include tear size and retraction, high-grade fatty infiltration (especially in the infraspinatus), muscle atrophy, humeral head elevation, and pseudoparalysis. Soft tissue operations—such as partial repair, superior capsule reconstruction, and tendon transfers—are preferred for younger, active patients with good preoperative function and the ability to restore soft tissue balance. In contrast, reverse arthroplasty is optimal for older patients, those with arthritis, lower demands, severe functional loss, inability to restore balance, or high risk of soft tissue operation failure. Arthroplasty offers faster recovery and better outcomes in complex cases. Understanding these factors aids in individualized treatment planning to enhance patient satisfaction and outcomes in managing massive rotator cuff tears.

Asset Caption

Instructional Course Lecture: My Patient Has an Irreparable Massive Rotator Cuff Tear: When Should I Use a Soft Tissue Reconstruction, When Should I Use an Arthroplasty, and How do I Get it Right?

Keywords

irreparable massive rotator cuff tears

soft tissue reconstruction

arthroplasty

predictors of irreparability

treatment planning