Skip to main content
SpringerLink
Log in

Rotator Cuff Tear in Athletes: Part III. Surgical Treatment

  • Chapter
Sports Injuries to the Shoulder and Elbow

  • 3100 Accesses

Abstract

The management of rotator cuff tears in athletes involves obtaining a careful history and differentiating acute traumatic from chronic overuse injuries. Performing a thorough physical examination can help corroborate the history. Imaging studies typically confirm the working diagnosis and supplement treatment decision-making. Understanding the biomechanics of rotator cuff repair is important when considering the surgical options during repair. Understanding the physical demands and expectations of the patient-athlete can further help to optimize sport-specific rehabilitation and outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Ahmad CS, Vorys GC, Covey A, Levine WN, Gardner TR, Bigliani LU. Rotator cuff repair fluid extravasation characteristics are influenced by repair technique. J Shoulder Elbow Surg. 2009;18:976–81. doi:10.1016/j.jse.2009.01.020.

    Article  PubMed  Google Scholar 

  2. Boyer P, Bouthors C, Delcourt T, Stewart O, Hamida F, Mylle G, et al. Arthroscopic double-row cuff repair with suture-bridging: a structural and functional comparison of two techniques. Knee Surg Sports Traumatol Arthrosc. 2013. doi 10.1007/s00167-013-2401-7.

  3. Burkhart SS, Adams CR, Burkhart SS, Schoolfield JD. A biomechanical comparison of 2 techniques of footprint reconstruction for rotator cuff repair: The SwiveLock-FiberChain construct versus standard double-row repair. Arthroscopy. 2009;25:274–81.

    Article  PubMed  Google Scholar 

  4. Cheung S, Dillon E, Tham SC, Feeley BT, Link TM, Steinbach L, et al. The presence of fatty infiltration in the infraspinatus: its relation with the condition of the supraspinatus tendon. Arthroscopy. 2011;27:463–70.

    Article  PubMed  Google Scholar 

  5. Cho NS, Lee BG, Rhee YG. Arthroscopic rotator cuff repair using a suture bridge technique: is the repair integrity actually maintained? Am J Sports Med. 2011;39:2108–16. doi:10.1177/0363546510397171.

    Article  PubMed  Google Scholar 

  6. Cho NS, Yi JW, Lee BG, Rhee YG. Retear patterns after arthroscopic rotator cuff repair: Single-row versus suture bridge technique. Am J Sports Med. 2010;38:664–71. doi:10.1177/0363546509350081.

    Article  PubMed  Google Scholar 

  7. Davidson DA, Burkhart SS. The geometric classification of rotator cuff tears: A system linking tear pattern to treatment and prognosis. Arthroscopy. 2010;26:417–24.

    Article  PubMed  Google Scholar 

  8. Foulk DA, Darmelio MP, Rettig AC, Misamore G. Full-thickness rotator-cuff tears in professional football players. Am J Orthop. 2002;31:622–4.

    PubMed  Google Scholar 

  9. Frank JB, ElAttrache NS, Dines JS, Blackburn A, Crues J, Tibone JE. Repair site integrity after arthroscopic “transosseous-equivalent/suture-bridge” rotator cuff repair. Am J Sports Med. 2008;36:1496–503. doi:10.1177/0363546507313574.

    Article  PubMed  Google Scholar 

  10. Gates JJ, Gilliland J, McGarry MH, Park MC, Acevedo D, Fitzpatrick MJ, et al. The influence of distinct anatomic subregions of the supraspinatus on humeral rotation. J Orthop Res. 2010;28:12–7.

    PubMed  Google Scholar 

  11. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med. 2007;35:719–28.

    Article  PubMed  Google Scholar 

  12. Goutallier D, Postel J, Gleyze P, Leguilloux P, Van Driessche S. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg. 2003;12:550–4.

    Article  PubMed  Google Scholar 

  13. Jost PW, Khair MM, Chen DX, Wright TW, Kelly AM, Rodeo SA. Suture number determines strength of rotator cuff repair. J Bone Joint Surg Am. 2012;94:e100(1–7). doi:10.2106/JBJS.K.00117.

  14. Kim KC, Shin HD, Cha SM, Park JY. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear: articular- versus bursal-side partial tears. Am J Sports Med. 2014;42:451–6.

    Article  PubMed  Google Scholar 

  15. Liem D, Lichtenberg S, Magosch P, Habermeyer P. Arthroscopic rotator cuff repair in overhead-throwing athletes. Am J Sports Med. 2008;36:1317–22. doi:10.1177/0363546508314794.

    Article  PubMed  Google Scholar 

  16. Mazoue CG, Andrews JR. Repair of full-thickness rotator cuff tears in professional baseball players. Am J Sports Med. 2006;34:182–9.

    Article  PubMed  Google Scholar 

  17. Oh JH, Jun BJ, McGarry MH, Lee TQ. Does a critical rotator cuff tear stage exist? A biomechanical study of rotator cuff tear progression in human cadaver shoulders. J Bone Joint Surg. 2011;93A:2100–09.

    Google Scholar 

  18. Oh JH, Oh CH, Kim SH, Kim JH, Yoon JP, Jung JH. Clinical features of partial anterior bursal-sided supraspinatus tendon (PABST) lesions. J Shoulder Elbow Surg. 2012;21:295–303.

    Article  PubMed  Google Scholar 

  19. Park MC. Biomechanical validation of rotator cuff repair techniques and considerations for a “technical efficiency ratio”. Arthroscopy. 2013;29:1230–4. doi:10.1016/j.arthro.2013.03.079.

    Article  PubMed  Google Scholar 

  20. Park MC, Bui C, Park CJ, Oh JH, Lee TQ. Rotator cuff tendon repair morphology comparing two single anchor repair techniques. Arthroscopy. 2013;29:1149–56.

    Article  PubMed  Google Scholar 

  21. Park MC, ElAttrache NS. Treating full-thickness cuff tears in the athlete: advances in arthroscopic techniques. Clin Sports Med. 2008;27:719–29. doi:10.1016/j.csm.2008.07.003.

    Article  PubMed  Google Scholar 

  22. Park MC, ElAttrache NS, Tibone JE, Ahmad CS, Jun BJ, Lee TQ. Part I: footprint contact characteristics for an arthroscopic transosseous-equivalent rotator cuff repair technique. J Shoulder Elbow Surg. 2007;16:461–8. doi:10.1016/j.jse.2006.09.010.

    Article  PubMed  Google Scholar 

  23. Park MC, Idjadi JA, ElAttrache NS, Tibone JE, McGarry MH, Lee TQ. The effect of dynamic external rotation comparing 2 footprint-restoring rotator cuff repair techniques. Am J Sports Med. 2008;36:893–900. doi:10.1177/0363546507313092.

    Article  PubMed  Google Scholar 

  24. Park MC, Jun BJ, Park CJ, Ahmad CS, ElAttrache NS, Lee TQ. The biomechanical effects of dynamic external rotation on rotator cuff repair compared to testing with the humerus fixed. Am J Sports Med. 2007;35:1931–9. doi:10.1177/0363546507304139.

    Article  PubMed  Google Scholar 

  25. Park JY, Lee SY, Chung SW, Zulkifli H, Cho JH, Oh KS. Clinical comparison between double-row and transosseous-equivalent repairs for medium to large size rotator cuff tears. Arch Orthop Trauma Surg. 2013;133:1727–34. doi:10.1007/s00402-013-1872-9.

    Article  PubMed  Google Scholar 

  26. Park MC, McGarry MH, Gunzenhauser RC, Benefiel MK, Park CJ, Lee TQ. Does transosseous-equivalent rotator cuff repair biomechanically provide a “self-reinforcement” effect compared to single-row repair? J Shoulder Elbow Surg. 2014;23(12):1813-21. doi:10.1016/j.jse.2014.03.008

  27. Park MC, Peterson A, Patton J, McGarry MH, Park CJ, Lee TQ. Biomechanical effects of a 2 suture-pass medial inter-implant mattress on transosseous-equivalent rotator cuff repair and considerations for a “technical efficiency ratio”. J Shoulder Elbow Surg. 2014;23:361–8. doi:10.1016/j.jse.2013.06.019. pii: S1058-2746(13)00296-6.

    Article  PubMed  Google Scholar 

  28. Park MC, Pirolo JM, Park CJ, McGarry MH, Tibone JE, Lee TQ. The effect of abduction and rotation on footprint contact for single-row, double-row, and transosseous-equivalent rotator cuff repair techniques. Am J Sports Med. 2009;37:1599–608. doi:10.1177/0363546509332506.

    Article  PubMed  Google Scholar 

  29. Park MC, Tibone JE, ElAttrache NS, Ahmad CS, Jun BJ, Lee TQ. Part II: biomechanical assessment for a footprint-restoring arthroscopic transosseous-equivalent rotator cuff repair technique compared to a double-row technique. J Shoulder Elbow Surg. 2007;16:469–76. doi:10.1016/j.jse.2006.09.011.

    Article  PubMed  Google Scholar 

  30. Pauly S, Fiebig D, Kieser B, Albrecht B, Schill A, Scheibel M. Biomechanical comparison of four double-row speed-bridging rotator cuff repair techniques with or without medial or lateral row enhancement. Knee Surg Sports Traumatol Arthrosc. 2011;19:2090–7. doi:10.1007/s00167-011-1517-x.

    Article  PubMed  Google Scholar 

  31. Pennington WT, Gibbons DJ, Bartz BA, Dodd M, Daun J, Klinger J, et al. Comparative analysis of single-row versus double-row repair of rotator cuff tears. Arthroscopy. 2010;26:1419–26. doi:10.1016/j.arthro.2010.03.013.

    Article  PubMed  Google Scholar 

  32. Rhee YG, Cho NS, Parke CS. Arthroscopic rotator cuff repair using modified Mason-Allen medial row stitch: knotless versus knot-tying suture bridge technique. Am J Sports Med. 2012;40:2440–7. doi:10.1177/0363546512459170.

    Article  PubMed  Google Scholar 

  33. Saupe N, Pfirrmann CW, Schmid MR, Jost B, Werner CM, Zanetti M. Association between rotator cuff abnormalities and reduced acromiohumeral distance. Am J Roentgenol. 2006;187:376–82.

    Article  Google Scholar 

  34. Sethi PM, Noonan BC, Cunningham J, Shreck E, Miller S. Repair results of 2-tendon rotator cuff tears utilizing the transosseous equivalent technique. J Shoulder Elbow Surg. 2010;19:1210–7. doi:10.1016/j.jse.2010.03.018.

    Article  PubMed  Google Scholar 

  35. Shin SJ, Oh JH, Chung SW, Song MH. The efficacy of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears without acromial spur: prospective comparative study. Arthroscopy. 2012;28:628–35.

    Article  PubMed  Google Scholar 

  36. Tibone JE, Elrod B, Jobe FW, Kerlan RK, Carter VS, Shields CL, et al. Surgical treatment of tears of the rotator cuff in athletes. J Bone Joint Surg. 1986;68-A:887–91.

    Google Scholar 

  37. Toussaint B, Schnaser E, Bosley J, Lefebvre Y, Gobezie R. Early structural and functional outcomes for arthroscopic double-row transosseous-equivalent rotator cuff repair. Am J Sports Med. 2011;39:1217–25. doi:10.1177/0363546510397725.

    Article  PubMed  Google Scholar 

  38. Voigt C, Bosse C, Vosshenrich R, Schulz AP, Lill H. Arthroscopic supraspinatus tendon repair with suture-bridging technique. Am J Sports Med. 2010;38:983–91. doi:10.1177/0363546509359063.

    Article  PubMed  Google Scholar 

  39. Wolff AB, Sethi PM, Sutton KM, Covey AS, Magit DP, Medvecky M. Partial-thickness rotator cuff tears. J Am Acad Orthop Surg. 2006;14:715–25.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Woodland Hills Medical Center, Kaiser Foundation Hospital, 5601 De Soto Avenue, Woodland Hills, CA, 91365, USA

    Maxwell C. Park MD

Authors
  1. Maxwell C. Park MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maxwell C. Park MD .

Editor information

Editors and Affiliations

  1. NEON Orthopaedic Clinic, Global Center for Shoulder, Elbow & Sports, Seoul, Korea, Republic of (South Korea)

    Jin-Young PARK

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Park, M.C. (2015). Rotator Cuff Tear in Athletes: Part III. Surgical Treatment. In: PARK, JY. (eds) Sports Injuries to the Shoulder and Elbow. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41795-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-41795-5_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-41794-8

  • Online ISBN: 978-3-642-41795-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation