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Zentralbl Chir 2002; 127(3): 194-202
DOI: 10.1055/s-2002-24250
Verletzungen der Schulter und oberen Extremität

© Georg Thieme Verlag Stuttgart · New York

Stand in der Versorgung der Rotatorenmanschettenruptur

Current Concepts in Treatment of Rotator Cuff TearsS. O. Dietz, P. Habermeyer, Petra Magosch
  • Schulter- und Ellenbogenchirurgie, ATOS-Praxisklinik, Heidelberg
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Publication History

Publication Date:
04 April 2002 (online)

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Zusammenfassung

Wegen eines hohen Funktionsanspruches an das Schultergelenk, bis in das hohe Alter, und den wachsenden Erfahrungen und Erfolgen der Schulterchirurgie, wird die Indikation zu einer Rotatorenmanschettenrekonstruktion häufiger gestellt. Ziel muss es sein, Algorithmen zu entwickeln, die ein patienten- und pathologiekonformes Vorgehen ermöglichen. Für ausgedehnte Rupturen stehen heute zahlreiche plastisch-chirurgische, aber auch Partialrekonstruktionen zur Verfügung. Bei inoperablen Massenrupturen mit begleitender Glenohumeralarthrose - d. h. Defektarthropathie - besteht die Möglichkeit eines endoprothetischen Gelenkersatzes mit einer inversen Schulterprothese nach Grammont. In diesem Artikel geben wir einen Überblick über den aktuellen Stand der Rotatorenmanschettenrekonstruktion.

Summary

The expectation of a functional shoulder joint, even in advanced age, the growing experience and success in shoulder surgery have brought the operative treatment another step further. The goal of any advanced knowledge should be a proper treatment of the patients and the pathology. Complex rotator cuff tears can be repaired by means of muscle transfer and partial reconstruction. In cases of irreparable rotator cuff tear arthropathy prosthetic replacement of the gleno-humeral joint can be performed. In this article a review on the different techniques and indications for rotator cuff repair is given.

Schlüsselwörter

Rotatorenmanschettenrekonstruktion - Rotatorenmanschettenläsion - Therapie - Indikation - Muskelersatzplastik

Key words

Rotator cuff repair - Rotator cuff tear - Therapy - Indication - Muscle transfer

Literatur

  • 1 Apoil A, Augereau B. Réperation par lambeau de deltoide des grandes pertes de substance de la coiffe des rotateurs de l'epaule.  Chirurgie. 1985;  11 287-290
    PubMedGoogle Scholar
  • 2 Baker C L, Liu S H. Comparison of open and arthroscopically assisted rotator cuff repairs.  Am J Sports Med. 1995;  23 99-104
    PubMedGoogle Scholar
  • 3 Bassett R W, Cofield R H. Acute tears of the rotator cuff. The timing of surgical repair.  Clin Orthop. 1983;  175 18-24
    PubMedGoogle Scholar
  • 4 Bigliani L U, Cordasco F A, McIlveen S J, Musso E S. Operative treatment of failed repairs of the rotator cuff.  J Bone Joint Surg [Am]. 1992;  74 1505-1515
    PubMedGoogle Scholar
  • 5 Bjorkenheim J M, Paavolainen P, Ahovuo J, Slatis P. Surgical repair of the rotator cuff and surrounding tissues. Factors influencing the results.  Clin Orthop. 1988;  236 148-153
    PubMedGoogle Scholar
  • 6 Bokor D J, Hawkins R J, Huckell G H, Angelo R L, Schickendantz M S. Results of nonoperative management of full-thickness tears of the rotator cuff.  Clin Orthop. 1993;  294 103-110
    PubMedGoogle Scholar
  • 7 Braune C, Habermeyer P. Der makroskopische Aspekt der Rotatorenmanschettenruptur bei traumatischen und atraumatischen Rupturformen.  Unfallchirurg. 2000;  103 462-467
    CrossrefPubMedGoogle Scholar
  • 8 Budoff J E, Nirschl R P, Guidi E J. Debridement of partial-thickness tears of the rotator cuff without acromioplasty. Long term follow-up and review of the literature.  J Bone Joint Surg [Am]. 1998;  80 733-748
    PubMedGoogle Scholar
  • 9 Burkhart S S, Athanasiou K A, Wirth M A. Margin convergence: A method of reducing strain in massive rotator cuff tears.  Arthroscopy. 1996;  12 335-338
    CrossrefPubMedGoogle Scholar
  • 10 Burkhart S S, Diaz Pagan J L, Wirth M A, Athanasiou K A. Cyclic loading of anchor based rotator cuff repairs: confirmation of the tension overload phenomenom and comparison of suture anchor fixation with transosseous fixation.  Arthroscopy. 1997;  13 172-176
    CrossrefPubMedGoogle Scholar
  • 11 Burkhart S S, Esch J C, Jolson R S. The rotator crescent and rotator cable: An anatomic description of the shoulder's “suspension bridge”.  Arthroscopy. 1993;  9 611-616
    CrossrefPubMedGoogle Scholar
  • 12 Burkhart S S, Fischer S P, Nottage W M. Tissue fixation security in transosseus rotator cuff repairs: A mechanical comparison of simple versus mattress sutures.  Arthroscopy. 1996;  12 704-708
    PubMedGoogle Scholar
  • 13 Burkhart S S, Nottage W M, Ogilvie-Harris D J, Kohn H S, Pachelli A. Partial repair of irreparable rotator cuff tears.  Arthroscopy. 1994;  10 363-370
    Google Scholar
  • 14 Burkhart S S. Arthroscopic rotator cuff repair: Indicatons and techniques.  Operative Techniques in Sports Med. 1997;  5 204-214
    PubMedGoogle Scholar
  • 15 Burkhart S S. The deadman theory of suture anchors: Observations along a South Texas fence line.  Arthroscopy. 1995;  11 119-123
    PubMedGoogle Scholar
  • 16 Burkhart S S. A steppwise approach to arthroscopic rotator cuff repair based on biomechanical principles.  Arthroscopy. 2000;  16 82-90
    PubMedGoogle Scholar
  • 17 Caldwell G L, Warner J P, Miller M D, Boardman D, Towers J, Debski R. Strength of fixation with transosseous sutures in rotator cuff repair.  J Bone Joint Surg [Am]. 1997;  79 1064-1068
    PubMedGoogle Scholar
  • 18 Caspari R B, Thal R. A technique for arthroscopic subacromial decompression.  Arthroscopy. 1992;  8 23-30
    PubMedGoogle Scholar
  • 19 Cofield R H, Parvizi J, Hoffmeyer P J, Lanzer W L, Ilstrup D M, Rowland C M. Surgical repair of chronic rotator cuff tears.  J Bone Joint Surg [Am]. 2001;  83 71-77
    CrossrefPubMedGoogle Scholar
  • 20 Cofield R H. Rotator cuff disease of the shoulder.  J Bone Joint Surg. 1985;  67 974-979
    PubMedGoogle Scholar
  • 21 Davidson P A, Rivenburgh D W. Rotator cuff repair tension as a determinant of functional outcome.  J Shoulder Elbow Surg. 2000;  9 502-506
    CrossrefPubMedGoogle Scholar
  • 22 Deutsch A, Altchek D W, Veltri D M, Potter H G, Warren R F. Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings and operative treatment.  Am J Sports Med. 1997;  25 13-22
    CrossrefPubMedGoogle Scholar
  • 23 Earnshaw P, Desjardins D, Sakkar K, Uhtoff H K. Rotator cuff tears: The role of surgery.  Canad J Surg. 1982;  25 60-63
    PubMedGoogle Scholar
  • 24 Ellman H. Arthroscopic subacromial decompression: a preliminary report.  Orthop Trans. 1985;  9 49
    PubMedGoogle Scholar
  • 25 Ellman H. Arthroscopic subacromial decompression: Analysis of 1-3 years results.  Arthroscopy. 1987;  3 173-181
    CrossrefPubMedGoogle Scholar
  • 26 Ellman H. Management of the irreparable rotator cuff and cuff artropathy. In: Ellman H, Gartsman GM (eds). Arthroscopic shoulder surgery and related procedures. Lea & Febinger, Philadelphia 1993
    Google Scholar
  • 27 Gartsman G M, Khan M, Hammerman S M. Arthroscopic repair of full-thickness tears of the rotator cuff.  J Bone Joint Surg [Am]. 1998;  80 832-840
    PubMedGoogle Scholar
  • 28 Gerber C, Schneeberger A G, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff.  J Bone Joint Surg [Br]. 1994;  76 371-380
    PubMedGoogle Scholar
  • 29 Gerber C. Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff.  Clin Orthop. 1992;  275 152-160
    PubMedGoogle Scholar
  • 30 Goldberg B A, Scarlet M, Matsen F A. Functional results of non operative management of full thickness rotator cuff tears. ASES - 16th Open Annual Meeting 2000, Orlando
    Google Scholar
  • 31 Hertel R, Windisch W, Schuster A, Ballmer F T. Transacromial approach to obtain fusion of unstable os acromiale.  J Shoulder Elbow Surg. 1998;  7 606-609
    CrossrefPubMedGoogle Scholar
  • 32 Hyvönen P, Lohi S, Jalovaara P. Open acromioplasty does not prevent the progression of an impingement syndrome to a tear. Nine-year follow-up of 96 cases.  J Bone Joint Surg [Br]. 1998;  80 813-816
    PubMedGoogle Scholar
  • 33 Itoi E, Tabata S. Conservative treatment of rotator cuff tear.  Clin Orthop. 1992;  275 165-173
    PubMedGoogle Scholar
  • 34 Jerosch J, Steinbeck J, Schröder M, Castro W H. Arthroscopic resection of the acromioclavicular joint.  Knee Surg Sports Traumatol Arthrosc. 1993;  1 209-215
    CrossrefPubMedGoogle Scholar
  • 35 Jost B, Pfirrmann C, Gerber C. Clinical outcome after surgical failure of rotator cuff repairs.  J Bone Joint Surg [Am]. 2000;  82 304-314
    CrossrefPubMedGoogle Scholar
  • 36 Kempf J F, Mole D, Gleyze P, Bonmonnet F, Rio B, Levigne C, Walch G. Results of endoscopic treatment of the tendinopathies of the rotator cuff (excluding total ruptures).  Rev Chir Orthop Reparatrice Appar Mot. 1993;  79 519-531
    PubMedGoogle Scholar
  • 37 Levy H J, Uribe J W, Delaney L G. Arthroscopic assisted rotator-cuff repair: preliminary results.  Arthroscopy. 1990;  6 55-60
    PubMedGoogle Scholar
  • 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 
    PubMedGoogle Scholar
  • 39 Löhr J F, Uhthoff H K. The microvascular pattern of the supraspinatus tendon.  Clin Orthop. 1990;  254 35-38
    PubMedGoogle Scholar
  • 40 Mallon W J, Bassett F H, Goldner R D. Luxatio erecta: the inferior glenohumeral dislocation.  J Orthop Trauma. 1990;  4 19-24
    PubMedGoogle Scholar
  • 41 McLaughlin H L. Lesions of the musculotendinous cuff of the shoulder. The exposure and treatment of tears with retraction. (Classic article 1944).  Clin Orthop. 1994;  304 3-4
    PubMedGoogle Scholar
  • 42 Neer C S. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report.  J Bone Joint Surg [Am]. 1972;  54 41-50
    PubMedGoogle Scholar
  • 43 Noel E. Les ruptures de la coiffe des rotateurs avec tête humerale centrée. Resultats de traitement conservateur. Journees Lyonnaisede l'Epaule 1993; Avril: 283-297
    Google Scholar
  • 44 Resch P P, Ritter E, Matschi W. Transfer of the pectoralis major muscle for the treatment of irreparable rupture of the subscapularis tendon.  J Bone Joint Surg [Am]. 2000;  82 372-382
    CrossrefPubMedGoogle Scholar
  • 45 Ryu R K. Basic principles and techniques for successful arthroscopic rotator cuff repair. AANA Specialty Day, San Francisco. March 2001
    Google Scholar
  • 46 Schmidt-Wiethoff R, Habermeyer P. Die Deltoideus-Lappenplastik bei der Massenruptur der Rotatorenmanschette.  Operat Orthop Traumatol. 1999;  11 (4) 255-267
    PubMedGoogle Scholar
  • 47 Seltzer D G, Basamania C, Rockwood C A. Conservative management of rotator cuff tears. In: Burkhead WZ Jr. Rotator cuff disorders. Williams and Wilkins 1996; 258-267
    Google Scholar
  • 48 Snyder S J. Technique of arthroscopic rotator cuff repair using implantable 4 mm Revo suture anchors, suture shuttle relays and #2 non-absorble mattress sutures. AANA Speciality Day New Orleans, LO, March 22, 1998
    Google Scholar
  • 49 Tauro J C. Arthroscopic rotator cuff repair: Analysis of technique and results at 2- and 3-year follow-up.  Arthroscopy. 1998;  14 45-51
    PubMedGoogle Scholar
  • 50 Walch G, Madonia G, Pozzi I, Riand N, Levigne C. Arthroscopic tenotomy of the long head of the biceps in rotator cuff ruptures. In: Gazielly DF, Gleyze P, Thomas T (eds). The cuff. Elsevier, Paris 1997; 350-355
    Google Scholar
  • 51 Walch G. Synthese sur l'epidemiologie et l'ethiologie des ruptures de la coiffe des rotateurs. Journ Lyonnaise Epaule 1993, 256-266
    Google Scholar
  • 52 Warner J P, Bim G M, Higgins L. The treatment of symptomatic os acromiale.  J Bone Joint Surg [Am]. 1998;  80 1320-1326
    PubMedGoogle Scholar
  • 53 Weber S C. All arthroscopic versus mini open rotator cuff repair. AANA Speciality Day New Orleans, LO, March 22, 1998
    Google Scholar
  • 54 Weber S C. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears.  Arthroscopy. 1999;  15 126-131
    CrossrefPubMedGoogle Scholar
  • 55 Weber S C. Co-planing the acrmioclavicular joint at the time of acromioplasty: A long-term study.  Arthroscopy. 1999;  15 555
    PubMedGoogle Scholar

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