Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis (AANA19)-Case Studies_ Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis-Dr. Brian R. Waterman, M.D.

Case Studies_ Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis-Dr. Brian R. Waterman, M.D.

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Video Transcription

Video Summary

In this detailed discussion among orthopedic experts, various approaches to managing rotator cuff tears, especially irreparable ones, were explored. Cortisone injections are used cautiously, with some preferring alternatives like Toradol due to concerns about tendon degradation. Superior Capsular Reconstruction (SCR) techniques, including graft sizing, positioning, and anchor constructs, were debated, emphasizing individualized patient assessment. The role of the biceps tendon in augmenting SCR, preserving the superior labrum, and efforts to repair the posterior cuff were highlighted. Challenges with infraspinatus tears and managing difficult cuff tissue were discussed, with tendon transfers reserved for rare isolated cases. The use of dermal allografts for augmentation showed improved healing rates, while collagen applications raised concerns due to inflammatory risks. Partial articular-sided tears (PASTA) often require selective repair strategies, sometimes combined with microfracture to enhance blood supply. The panel underscored tailoring treatments to patient needs, acknowledging that outcomes vary and surgical decisions depend on multiple factors, including tear size, tissue quality, and patient activity.

Asset Caption

Instructional Course Lecture: Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis

Keywords

rotator cuff tears

Superior Capsular Reconstruction

cortisone injections

biceps tendon augmentation

dermal allografts

partial articular-sided tears