Management of the “Irreparable” Rotator Cuff Tear without Glenohumeral Arthritis (AANA19)-Massive Irreparable Rotator Cuff Tear without Glenohumeral Arthritis_ My Pearls for Primary Repair-Dr. Brian R. Waterman, M.D.

Massive Irreparable Rotator Cuff Tear without Glenohumeral Arthritis_ My Pearls for Primary Repair-Dr. Brian R. Waterman, M.D.

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Video Transcription

Video Summary

This talk reviews primary repair techniques for large to massive rotator cuff tears, emphasizing the complexity of defining irreparability and the importance of individualized assessment. Key points include identifying tear patterns, carefully performing releases to improve tendon mobility, and sequentially repairing the subscapularis, infraspinatus, and supraspinatus to restore function. Biomechanics, biology, and patient factors must be optimized for success. Functional partial repairs and footprint medialization are useful strategies, while suture tape constructs offer biomechanical advantages. Addressing concomitant pathology and recruiting native biology via techniques like the "crimson duvet" enhance outcomes. Future directions focus on biologic adjuncts and improved fixation methods.

Asset Caption

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

Keywords

rotator cuff repair

irreparability assessment

tendon mobility

suture tape constructs

biologic adjuncts