Treatment of large, massive irreparable rotator cuff tears

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Abstract

The rotator cuff is a complex anatomical and biomechanical structure which allows stabilization of the shoulder joint in the correct position and movements in it. The rotator cuff tears remain the most frequent injury as compared to those of other anatomical structures of the shoulder joint and reach the incidence of 21%, according to a number of authors. Such injuries are prone to inducing a fat replacement of muscle tissues in elderly patients against the background of degenerative changes in the structure of the rotator cuff. These injuries are hard-to-heal, and the incidence of relapses after the surgical treatment reaches 20–90%, according to several authors. Based on the investigation of the postoperative treatment failures, alternative methods for the replacement, transfer or surgical repair of damaged tendons are adopted, but there is still no single approach and method in the treatment of this pathology. In this literature review, we have analyzed the data on the anatomical structure and biomechanics of the rotator cuff, the role of the rotator cuff damage in the dysfunction of the shoulder joint and possible methods for its recovery.

About the authors

Maxim F. Lazko

Peoples Friendship University of Russia, Medical Institute

Author for correspondence.
Email: Maxim_lazko@mail.ru

Md, resident of department traumatology and Orthopaedics, PFUR

Russian Federation, Moscow

Alexey P. Prizov

Peoples Friendship University of Russia, Medical Institute

Email: aprizov@yandex.ru

к.м.н., доцент кафедры травматологии и ортопедии РУДН, зав. учебной частью кафедры, врач травматолог-ортопед

Russian Federation, Moscow

Fedor L. Lazko

Peoples Friendship University of Russia, Medical Institute

Email: Fedor_lazko@mail.ru

д.м.н., профессор кафедры травматологии и ортопедии

Russian Federation, Moscow

Eugene A. Belyak

Peoples Friendship University of Russia, Medical Institute

Email: belyakevgen@mail.ru

к.м.н., ассистент кафедры травматологии и ортопедии

Russian Federation, Moscow

Ivanе G. Maglaperidze

Peoples Friendship University of Russia, Medical Institutesia

Email: v.maglapheridze@mail.ru

аспирант кафедры травматологии и ортопедии РУДН, врач травматолог-ортопед

Russian Federation, Moscow

Alexander V. Kuznetsov

Peoples Friendship University of Russia, Medical Institute

Email: Dr.smith_a@icloud.com

клинический ординатор кафедры травматологии и ортопедии

Russian Federation, Moscow

Alexander A. Akhpashev

Peoples Friendship University of Russia, Medical Institute; Academy of Postgraduate Education under the Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: akhpashev@gmail.com

доцент кафедры травматологии и ортопедии РУДН, врач травматолог-ортопед; к.м.н., зав. кафедрой травматологии и ортопедии

Russian Federation, Moscow

Timofey O. Skipenko

Peoples Friendship University of Russia, Medical Institute

Email: skipenko@mail.ru

к.м.н., доцент кафедры травматологии и ортопедии РУДН, зав. 12-м отделением травматологии и ортопедии Национального медицинского исследовательского центра травматологии и ортопедии имени Н.Н. Приорова (ЦИТО)

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. SCR graft placement

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3. Fig. 2. Transposition of the latissimus tendon by a half-open method

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4. Fig. 3. Installation diagram of a subacromial balloon

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Copyright (c) 2020 Lazko M.F., Prizov A.P., Lazko F.L., Belyak E.A., Maglaperidze I.G., Kuznetsov A.V., Akhpashev A.A., Skipenko T.O.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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