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-Tauro

Video Transcription

Video Summary

The presentation focused on large rotator cuff tears, primarily defining and classifying tear sizes based on tendon involvement and MRI assessment. Large tears commonly involve two tendons, especially posterior-superior tears (supraspinatus, infraspinatus) and anterior-superior tears (supraspinatus, subscapularis). Early surgical intervention is favored for young, active patients due to better long-term outcomes, avoiding tear progression. The speaker emphasized preoperative MRI analysis and intraoperative assessment of tendon mobility as critical for deciding repair strategy and duration.<br /><br />Three cases illustrated different clinical scenarios: first, a mobile large tear treated with single-row repair without soft tissue release; second, a more complex tear requiring a ripstop stitch technique with a patch and bone marrow aspirate concentrate (BMAC) for biological augmentation; and third, an irreparable large tear where partial repairs and soft tissue releases (anterior and superior capsular releases) were essential for improving tendon excursion and function.<br /><br />Discussion included repair techniques, the evolving role of subscapularis repair, and management of the biceps tendon. Leaving an intact biceps tendon untouched or integrating it into the repair to act as a superior capsule reconstruction (SCR) was considered an effective adjunct. The importance of tailored surgical approaches, understanding tear geometry, and potential use of biological and mechanical augmentation to optimize outcomes was underscored.

Asset Caption

Dr. Joseph C. Tauro

Keywords

large rotator cuff tears

tendon involvement

MRI assessment

surgical intervention

repair techniques

biological augmentation

biceps tendon management