Rotator cuff tears
Summary
Rotator cuff tears can result seperately or from any combination of vascular, degenerative,
mechanical, or traumatic causes. A correct diagnosis is sometimes difficult since
the clinical findings and symptoms vary largely. Treatment requires an early surgical
intervention either with a suture of the tear or a reconstruction in case of larger
tears or defects depending on the tear size, since early surgical treatment leads
to better results. With surgery also it is more likely to prevent cuff arthropathy
with subsequent joint destruction and painful loss of function.
Zusammenfassung
Rotatorenmanschettenrupturen entstehen durch vaskuläre, degenerative, mechanisch anatomische
und traumatische Ursachen sowie durch ein Zusammenwirken einzelner oder mehrerer dieser
Faktoren. Die Diagnostik ist nicht immer leicht, da das klinische Bild durch variierende
Symptome und Befunde sehr unterschiedlich ausfallen kann. Für die Therapie von Rotatorenmanschettenrupturen
ist eine frühzeitige Naht bzw. Rekonstruktion der Ruptur bzw. des Defektes anzustreben,
da einerseits bei frühzeitiger Versorgung mit besseren Ergebnissen gerechnet werden
kann, andererseits, um der Ausbildung von Spätschäden wie z. B. der Defektarthropathie
mit Gelenkzerstörung und schmerzhaftem Funktionsverlust vorzubeugen.
Key words
Rotator cuff - rotator cuff injury - rotator cuff tear - rotator cuff surgery - diagnostics
- reconstruction of cuff defects - plastic procedures
Schlüsselwörter
Rotatorenmanschette - Rotatorenmanschettenverletzung - Rotatorenmanschettenruptur
- Sehnenruptur - Diagnostik - Pathogenese - Rekonstruktion der Rotatorenmanschette
- plastische Deckung von Sehnendefekten
Literatur
- 1 Adams J C. Outline of orthopaedics. 5th edn. Livingstone, Edinburgh 1964
- 2
Altchek D W, Warren R F, Wickiewicz T L, Skyhar M J, Ortiz G, Schwartz E.
Arthroscopic acromioplasty. Technique and results.
J Bone Joint Surg [Am].
1990;
72
1198-1207
- 3
Apoil A, Augereau B.
Reparation par lambeau deltoidien des grandes pertes de substance de la coiffe des
rotateurs de l'epaule.
Chirurgie.
1985;
111
287-290
- 4 Apoil A, Dautry P, Koechlin Ph, Hardy J. The surgical treatment of rotator cuff
impingement. In: Bayley IB, Kessel L (eds). Shoulder surgery. Springer, Berlin, Heidelberg,
New York 1982
- 5
Augereau B.
Rekonstruktion massiver Rotatorenmanschettenrupturen mit einem Deltoidlappen.
Orthopäde.
1991;
20
315-319
- 6
Augereau B, Apoil A.
Reparation par lambeau deltoidien des grandes pertes de substance de la coiffe des
rotateurs de l'epaule.
Rev Chir Orthop.
1988;
74
298-301
- 7
Baker C L, Liu S H.
Comparison of open and arthroscopically assisted rotator cuff repairs.
Am J Sports Med.
1995;
23
99-104
- 8
Bassett R W, Cofield R H.
Acute tears of the rotator cuff: Timing of surgical repair.
Clin Orthop.
1983;
175
18-24
- 9
Bateman J E.
The diagnosis and treatment of tears of the rotator cuff.
Surg Clin North Am.
1963;
43
1523-1530
- 10 Bateman J E. The shoulder and neck. Saunders, Philadelphia 1972
- 11
Bigliani L U, D'Alessandro D F, Duralde X A, McIlveen S J.
Anterior acromioplasty for subacromial impingement in patients younger than 40 years
of age.
Clin Orthop.
1989;
246
111-116
- 12
Blevins F T, Warren R F, Cavo C, Altchek D W, Dines D, Palletta G, Wickiewicz T L.
Arthroscopic assisted rotator cuff repair: results using a mini-open deltoid splitting
approach.
Arthroscopy.
1996;
12
50-59
- 13
Cammerer U, Habermeyer P, Plenk A, Huber R.
Die sonographische Beurteilung rekonstruierter Rotatorenmanschetten.
Unfallchirurg.
1992;
95
608-612
- 14 Codman E A. The shoulder: Rupture of the supraspinatus tendon and other lesions
in or about the subacromial bursa. Thomas Todd, Boston 1934
- 15
Cofield R H.
Tears of the rotator cuff.
Instr Course Lect.
1981;
30
258
- 16
Cofield R H.
Subscapular muscle transposition for repair of chronic rotator cuff tears.
Surg Gynecol Obstet.
1982;
154
667-672
- 17
Cordasco F A, Bigliani L U.
The rotator cuff: Large and massive tears. Technique of open repair.
Orthop Clin North Am.
1997;
28
179-193
- 18
Cordasco F A, Bigliani L U.
The treatment of failed rotator cuff repairs.
Instr Course Lect.
1998;
47
77-86
- 19
Debeyre J, Patte D, Elmelik E.
Repair of rupture of the rotator cuff of the shoulder with a note on advancement of
the supraspinatus muscle.
J Bone Joint Surg [Br].
1965;
47
36-42
- 20
DePalma A F.
Surgical anatomy of the rotator cuff and the natral history of degenerative periarthritis.
Surg Clin North Am.
1963;
43
1507-1520
- 21 DePalma A F. Surgery of the shoulder. Saunders, Philadelphia 1983
- 22
Donovan W H, Kraft G.
Rotator cuff tears versus suprascapular nerve injury: A problem in differential diagnosis.
Arch Phys Med Rehab.
1974;
55
424-428
- 23
Earnshaw P, Desjardins D, Sarkar K, Uhthoff H K.
Rotator cuff tears: The role of surgery.
Can J Surg.
1982;
25
60-63
- 24
Ellman H.
Arthroscopic subacromial decompression: analysis of one-to three-year results.
Arthroscopy.
1987;
3
173-181
- 25
Ellman H.
Diagnosis and treatment of incomplete rotator cuff tears.
Clin Orthop Rel Res.
1990;
254
64-71
- 26
Ellman H, Kay S P, Wirth M.
Arthroscopic treatment of full-thickness rotator cuff tears: 2- to 7-year follow-up
study.
Arthroscopy.
1993;
9
195-200
- 27
Furtschegger A, Resch H.
Value of ultrasonography in preoperative diagnosis of rotator cuff tears and postoperative
follow-up.
Eur J Radiol.
1988;
8
69-75
- 28
Gartsman G M.
Arthroscopic acromioplasty for lesions of the rotator cuff.
J Bone Joint Surg [Am].
1990;
72
169-180
- 29
Gartsman G M.
Combined arthroscopic and open treatment of tears of the rotator cuff.
Instr Course Lect.
1998;
47
51-57
- 30
Goss T P.
Rotator cuff injuries.
Orthop Rev.
1986;
15
496-503
- 31
Goutallier D, Postel J M, Boudon R, Lavau L, Bernageau J.
Etude du risque neurologique a l'avancement tendino-musculaire des supra-epineux et
infra-epineux dans les reparations des larges ruptures de coiffe.
Rev Chir Orthop Reparatrice Appar Mot.
1996;
82
299-305
- 32
Ha'eri G B, Wiley A M.
“Supraspinatus slide” for rotator cuff repair.
Int Orthop.
1980;
4
231-234
- 33
Ha'eri G B, Wiley A M.
Advancement of the supraspinatus muscle in the repair of ruptures of the rotator cuff.
J Bone Joint Surg [Am].
1981;
63
232-238
- 34
Hartig A, Rojczyk M.
Die arthroskopische subakromiale Dekompression. Anmerkungen zur Indikation und Operationstechnik.
Unfallchirurg.
1993;
96
109-115
- 35
Hawkins R H, Hawkins R J.
Failed anterior reconstruction for shoulder instability.
J Bone Joint Surg [Br].
1985;
67
709-714
- 36
Heikel H VA.
Rupture of the rotator cuff of the shoulder. Experience of surgical treatment.
Acta Orthop Scand.
1968;
39
477-492
- 37
Jalovaara P, Puranen J, Lindholm R V.
Decompressive surgery in the tendinitis and tear stages of rotator cuff disease.
Acta Orthop Belg.
1989;
55
581-587
- 38
Liu S H, Baker C L.
Arthroscopically assisted rotator cuff repair: correlation of functional results with
integrity of the cuff.
Arthroscopy.
1994;
10
54-60
- 39 Magnusson R. Nordisk loerobok i ortopedi. Bonniers, Stockholm 1959
- 40
McLaughlin H L.
Lesions of the musculotendinous cuff of the shoulder: The exposure and treatment of
tears with retraction.
J Bone Joint Surg [Am].
1944;
26
31-51
- 41
McLaughlin H L.
Ruptures of the rotator cuff.
J Bone Joint Surg [Am].
1962;
44
979-983
- 42
McLaughlin H L.
Repair of major cuff ruptures.
Surg Clin North Am.
1963;
43
1535-1540
- 43
McMasters P E.
Tendon and muscle ruptures. Clinical and experimental studies on the course and location
of subcutaneous ruptures.
J Bone Joint Surg [Am].
1933;
15
705-722
- 44
Melillo A S, Savoie F H 3, Field L D.
Massive rotator cuff tears: debridement versus repair.
Orthop Clin North Am.
1997;
28
117-124
- 45
Meyer L, Burman M S.
Arthroscopy in the diagnosis of meniscal lesions of the knee joint.
Am J Surg.
1939;
43
501-511
- 46
Moseley H F, Goldie I.
The arterial pattern of the rotator cuff on the shoulder.
J Bone Joint Surg [Am].
1963;
45
780-789
- 47
Neer C S 2.
Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary
report.
J Bone Joint Surg [Am].
1972;
54
41-50
- 48
Neer C S 2.
Impingement lesions.
Clin Orthop.
1983;
173
70-77
- 49
Neviaser J S, Neviaser R J, Neviaser T J.
The repair of chronic massive ruptures of the rotator cuff of the shoulder by use
of freeze-dried rotator cuff.
J Bone Joint Surg [Am].
1978;
60
681-684
- 50
Neviaser R J.
Ruptures of the rotator cuff.
Orthop Clin North Am.
1987;
18
387-394
- 51
Neviaser R J.
Evaluation and management of failed rotator cuff repairs.
Orthop Clin North Am.
1997;
28
215-224
- 52 Neviaser R J, Neviaser T J. Transfer of subscapularis and teres minor for massive
defects of rotator cuff. In: Bayley IB, Kessel L (eds). Shoulder surgery. Springer,
Berlin, Heidelberg, New York 1982
- 53 Neviaser R J, Neviaser T J. Reconstruction of chronic tears of the rotator cuff. In:
Bateman JE, Welsh PR (eds). Surgery of the shoulder. Mosby, St. Louis 1984
- 54
Neviaser R J, Neviaser T J.
Recurrent instability of the shoulder after age 40.
J Shoulder Elbow Surg.
1995;
4
416-418
- 55
Neviaser R J, Neviaser T J, Neviaser J S.
Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in
the older patient.
J Bone Joint Surg [Am].
1988;
70
1308-1311
- 56
Neviaser T J, Neviaser R J, Neviaser J S.
Incomplete rotator cuff tears. A technique for diagnosis and treatment.
Clin Orthop.
1994;
306
12-16
- 57
Nixon J E, DiStefano V.
Ruptures of the rotator cuff.
Orthop Clin North Am.
1975;
6
423-447
- 58
Ogilvie Harris D J, Demaziere A.
Arthroscopic debridement versus open repair for rotator cuff tears. A prospective
cohort study.
J Bone Joint Surg [Br].
1993;
75
416-420
- 59
Olsewski J M, Depew A D.
Arthroscopic subacromial decompression and rotator cuff debridement for stage II and
stage III impingement.
Arthroscopy.
1994;
10
61-68
- 60
Olsson O.
Degenerative changes in the shoulder joint and their connection with shoulder pain.
A morphologic and clinical investigation with special attention to the cuff and the
biceps tendon.
Acta Chir Scand.
1953;
181 (Suppl)
1-130
- 61
Ozaki J, Fujimoto S, Masuhara K, Tamai S, Yoshimoto S.
Reconstruction of chronic massive rotator cuff tears with synthetic materials.
Clin Orthop.
1986;
202
173-183
- 62
Patte D, Goutallier D, Debeyre J.
Rotatorenmanschettenruptur. Ergebnisse und Perspektiven der Retrostruktur.
Orthopäde.
1981;
10
206-215
- 63
Paulos L E, Kody M H.
Arthroscopically enhanced “miniapproach” to rotator cuff repair.
Am J Sports Med.
1994;
22
19-25
- 64
Pevny T, Hunter R E, Freeman R R.
Primary traumatic anterior shoulder dislocation in patients 40 years of age and older.
Arthroscopy.
1998;
14
289-294
- 65
Plafki C, Hedtmann A, Fett H, Lutke A, Willburger R E.
Ergebnisse der operativen Therapie von Rupturen der Rotatorenmanschette der Schulter.
Z Orthop Grenzgeb.
1997;
135
360-367
- 66
Rathbun J B, MacNab I.
The microvascular pattern of the rotator cuff.
J Bone Joint Surg [Br].
1970;
52
540-553
- 67
Reiser M, Erlemann R, Bongartz G, Pauly T, Mathiaß H H, Peters E E.
Möglichkeiten der Magnetischen Resonanz-Tomographie (MRT) in der Diagnostik des Schultergelenkes.
Radiologe.
1988;
28
79-83
- 68
Rockwood C AJ, Burkhead W Z.
Management of patients with massive rotator cuff defects by acromioplasty and cuff
debridement.
Orthop Trans.
1988;
12
190-191
- 69
Rosenberg P S, Clarke R P.
Chronic rotator cuff tears.
Orthop Rev.
1986;
15
280-289
- 70
Rothman R H, Parke W W.
The vascular anatomy of the rotator cuff.
Clin Orthop.
1965;
41
176-186
- 71 Rowe C R. The shoulder. Churchill Livingstone, New York, Edinburgh 1988
- 72
Ryu R K.
Arthroscopic subacromial decompression: a clinical review.
Arthroscopy.
1992;
8
141-147
- 73
Sahlstrand T.
Operations for impingement of the shoulder. Early results in 52 patients.
Acta Chir Scand.
1989;
60
45-48
- 74
Seeger L L.
Magnetic resonance imaging of the shoulder.
Clin Orthop.
1989;
244
48-59
- 75
Smith J G.
Pathological appearances of seven cases of injury of the shoulder joint with remarks.
London Med Gazette.
1834;
14
280
- 76
Sonnabend D H.
Treatment of primary anterior shoulder dislocation in patients older than 40 years
of age. Conservative versus operative.
Clin Orthop.
1994;
304
74-77
- 77
Sperner G, Resch H, Golser K.
Klinisches Management bei Läsionen der Rotatorenmanschette.
Unfallchirurg.
1990;
93
309-314
- 78
Sperner G, Resch H, Golser K, Lener M, Seykora P.
Die Wertigkeit der Sonographie bei Rupturen der Rotatorenmanschette.
Unfallchirurg.
1993;
96
119-123
- 79
Thür C, Jülke M.
Die anterolaterale Deltoideuslappenplastik: das Verfahren der Wahl bei großen Rotatorenmanschettendefekten.
Unfallchirurg.
1995;
98
415-421
- 80
Ticker J B, Warner J J.
Single-tendon tears of the rotator cuff. Evaluation and treatment of subscapularis
tears and principles of treatment for supraspinatus tears.
Orthop Clin North Am.
1997;
28
99-116
- 81
Watson M.
Major ruptures of the rotator cuff. The results of surgical repair in 89 patients.
J Bone Joint Surg [Br].
1985;
67
618-624
- 82
Weiner D S, Macnab I.
Ruptures of the rotator cuff: Follow-up evaluation of operative repairs.
Can J Surg.
1970;
13
219-227
- 83
Weiner D S, Macnab I.
Superior migration of the humerus: A radiologic aid in diagnosis of tears of the rotator
cuff.
J Bone Joint Surg [Br].
1970;
52
524-527
- 84
Wiley A M.
Superior humeral dislocation. A complication following decompression and debridement
for rotator cuff tears.
Clin Orthop.
1991;
263
135-141
- 85
Wolfgang G H.
Surgical repair of tears of the rotator cuff of the shoulder. Factors influencing
the result.
J Bone Joint Surg [Am].
1974;
56
14-26
- 86
Zvijac J E, Levy H J, Lemak L J.
Arthroscopic subacromial decompression in the treatment of full thickness rotator
cuff tears: A 3- to 6-year follow-up.
Arthroscopy.
1994;
10
518-523
Prof. Dr. Norbert Südkamp
Abteilung Unfallchirurgie
Chirurgische Universitätsklinik
Hugstetter Straße 55
D-79106 Freiburg
