Aim: review the current literature on options of treatment for massive rotator cuff tear

Sources of data: The information was researched on the Pubmed using the following keywords: “massive”, “rotator”, “cuff”, “tear”, “treatment”. The survey was restricted to articles in english or portuguese, with less than 5 years. After selection 55 articles were used.

Summary of data: Massive Rotator Cuff Tear is an orthopaedic challenge with a technically hard repair and a recurrence rate distinctively higher than the smaller tears rate. Its treatment has a high failure rate, which is influenced by factors such as patient’s age, fatty degeneration and muscular retraction. The treatment choice should be based on patient’s age, functional demands and symptoms.

Conclusions: There are several options for the treatment of rotator cuff tears. Conservative treatment achieved good results in many patients, leaving many of them assymptomatic and with satisfactory function. The arthroscopic débridement, subacromial decompression and bicips tenotomy have as main objective the symptomatic relief and may be indicated in elderly patients with low functional demands, whose major complaint is pain. Repair should be tried specially in young symptomatic high-demand patients. Both hemiarthroplasty as reverse arthroplasty may be indicated in massive rupture and cuff arthropathy, being reverse arthroplasty the most effective treatment, although the not negligible mid-term complication rate.


Key words:
Massive, rotator, cuff, tear, treatment


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