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Rotator Cuff Pathology

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Textbook of Shoulder Surgery

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Abstract

The most common signs of rotator cuff tears are pain from subacromial impingement, muscle weakness in the shoulder joint, and, as a result, functional impairment including limitation of range of motion. These signs result mainly from a loss of the superior stability of the glenohumeral joint because of dysfunction of the rotator cuff muscles. The literature regarding the natural history of rotator cuff tears includes few cases of spontaneous healing, and most untreated rotator cuff tears show anatomic and clinical progression over time. Conservative treatment is effective for many rotator cuff tears and comprises injecting corticosteroid or sodium hyaluronate into the subacromial space and physical therapy to increase the strength of residual muscles and ameliorate shoulder stiffness. To obtain anatomic healing, the torn rotator cuff tendons must be repaired. Surgical repair has shown excellent clinical results in most studies. However, surgical treatment for chronic and large rotator cuff tears needs to be improved, especially for those in elderly patients, who continue to demonstrate high failure rates. For irreparable rotator cuff tears, alternative treatments include superior capsule reconstruction, reverse total-shoulder arthroplasty, tendon transfer, and partial repair. This chapter provides an overview of current treatment options for rotator cuff tears and summarizes ongoing research efforts to increase the number and success rates of available treatment options.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan

    Teruhisa Mihata

  2. Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA

    Teruhisa Mihata

  3. First Towakai Hospital, Takatsuki, Osaka, Japan

    Teruhisa Mihata

  4. Katsuragi Hospital, Kishiwada, Osaka, Japan

    Teruhisa Mihata

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  1. Teruhisa Mihata
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Correspondence to Teruhisa Mihata .

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Editors and Affiliations

  1. Wrightington Hospital, Wigan, Lancashire, UK

    Ian A. Trail

  2. Wrightington Hospital, Wigan, Lancashire, UK

    Lennard Funk

  3. Orthopaedic Surgery Department, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK

    Amar Rangan

  4. Trauma & Orthopaedics Department, Countess of Chester Hospital, Chester, Cheshire, UK

    Matthew Nixon

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Mihata, T. (2019). Rotator Cuff Pathology. In: Trail, I., Funk, L., Rangan, A., Nixon, M. (eds) Textbook of Shoulder Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-70099-1_8

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