Large Rotator Cuff Tears: Repair, Release, Patch, SCR, Reverse: A Case-Based Symposium (2021 Annual Meeting)-Large Rotator Cuff Tears_ Repair, Release, Patch, SCR, Reverse

Large Rotator Cuff Tears_ Repair, Release, Patch, SCR, Reverse_ A Case-Based Symposium-St. Pierre

Video Transcription

Video Summary

The presentation discussed surgical options for massive irreparable rotator cuff tears, focusing on when to choose reverse shoulder arthroplasty versus other treatments. Using the Near-Circle Delphi study, which gathered consensus from 72 expert shoulder surgeons, key factors influencing treatment decisions were identified: pseudoparesis, age, subscapularis status, dynamic instability, demand level, and others. The study found strong consensus favoring reverse arthroplasty primarily in patients over 70 with pseudoparesis and irreparable subscapularis tears, while younger patients were recommended for repair, grafts, or tendon transfers. Superior capsule reconstruction was contraindicated in certain older patients where reverse was preferred. The reverse procedure showed excellent functional outcomes with proper rehabilitation, enabling patients to return to sports and active lifestyles. The study’s guidelines serve as a decision tool but emphasize individual patient preferences and clinical judgment. An app is planned to assist clinicians in applying consensus-based treatment pathways for these complex shoulder conditions.

Asset Caption

Dr. Patrick St. Pierre

Keywords

massive irreparable rotator cuff tears

reverse shoulder arthroplasty

Near-Circle Delphi study

pseudoparesis

subscapularis status

superior capsule reconstruction