Treatment Innovations for Massive & Irreparable Rotator Cuff Tears (AANA22)-Massive Rotator Cuff Options for the Difficult Tear

Video Transcription

Video Summary

Dr. Buddy Savoie discusses the management of massive rotator cuff tears, challenging the concept of "irreparable" tears. He emphasizes that with proper surgical releases, tissue handling, and repair techniques, many so-called irreparable tears can be addressed. Key factors affecting repairability include tear size, tissue quality, superior migration, and muscle atrophy, with functional outcomes depending on the degree of atrophy. Preoperative evaluation, balancing biology and biomechanics, careful tissue releases, minimizing anchors, preserving blood supply, and meticulous repair techniques are critical. He highlights adjuncts like patches, grafts, biceps augmentation, subacromial spacers, and tendon transfers to improve outcomes. Postoperative care stresses cautious rehab, nutrition, and supplements to enhance healing. Decision-making is individualized based on patient needs, anatomy, and surgical options, with reverse shoulder arthroplasty reserved for severe cases with poor muscle quality or arthritis. Overall, Savoie advocates a comprehensive, nuanced approach to optimizing function and pain relief in massive cuff tears.

Asset Caption

Felix "Buddy" H. Savoie, M.D.

Keywords

massive rotator cuff tears

irreparable tears

surgical repair techniques

tissue quality and atrophy

adjunctive treatments

postoperative rehabilitation