• After a trial of conservative management, a wide array of surgical options exists for massive irreparable RCTs, which include rotator cuff debridement, partial rotator cuff repair, biceps tenotomy and tenodesis, tendon transfers, superior capsule reconstruction, subacromial balloon, and reverse shoulder arthroplasty [4]. (fortuneonline.org)
  • Other less common surgeries that Anakwenze offers include tendon transfers, reverse shoulder replacements, and superior capsular reconstruction using tissue grafts for massive, irreparable rotator cuff tears. (dukehealth.org)
  • Trenhaile SW, "Massive rotator cuff tear treatment: Superior capsular reconstruction-where does it apply? (scotttrenhailemd.com)
  • Trenhaile SW, "Superior Capsular Reconstruction versus Tendon Transfers versus Biologics: Considerations for Irreparable Cuff Tears", Podium presentation, New Orleans International Advanced Shoulder Symposium, Westin Canal Place, New Orleans, LA. October 4, 2019. (scotttrenhailemd.com)
  • A clinical study comparing surgical methods for the treatment of massive rotator cuff tears found equivalency in patient-reported outcomes between two predominant treatment approaches: tendon transfers and superior capsular reconstruction. (massgeneral.org)
  • The results of the study showed that there was no difference in the process of recovery or the patient-reported outcomes after a two-year minimum follow-up between tendon transfer and superior capsular reconstruction. (massgeneral.org)
  • His opinion, which does not draw directly from the clinical results, is that tendon transfers are better for patients who lack external rotation strength before treatment, whereas superior capsular reconstruction is a better treatment for patients with irreparable tears who still have some external rotation strength. (massgeneral.org)
  • Background Labral reconstruction has been described as a treatment option for irreparable labral tear. (researchgate.net)
  • Massive tears may be better treated with superior capsular reconstruction, tendon transfers, or reverse total shoulder arthroplasty. (gruttermd.com)
  • Superior capsular reconstruction is a technique that provides an anatomic reconstruction of the superior capsule of the glenohumeral joint, with the goal of restoring the normal restraint to superior translation that is lost with a deficient superior rotator cuff. (drmillett.com)
  • Saccomanno MF, Fodale M, Capasso L, Cazzato G, Milano G. Reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft: a pilot study. (maristellasaccomanno.com)
  • He has an interest in developing novel techniques of reconstructive arthroscopic (keyhole) surgery, including superior capsular reconstruction for patients with irreparable rotator cuff tears. (bupa.co.uk)
  • Compared to shoulder arthroplasty, tendon transfers have no concern for implant failure or implant longevity, making tendon transfers an optimal treatment option in this specific patient population [9]. (fortuneonline.org)
  • Peer-reviewed articles authored by Dr. Freehill explore rotator cuff injuries, shoulder arthroplasty, baseball-related injuries and performance interests, and more. (stanford.edu)
  • Dr. Peter Chalmers published a paper entitled, "Revision Reverse Total Shoulder Arthroplasty With Pectoralis Major Transfer for Anterior Deltoid Deficiency: A Case Report" in the Journal of Bone and Joint Surgery Case Connector. (chalmersmd.com)
  • Beside his continuous clinical activity, he has also described novel surgical procedures such as the latissimus dorsi transfer for a pseudoparalytic shoulder and he has described several important pathologies, such as the isolated rupture of the subscapularis tendon. (wikipedia.org)
  • The frequency of full-thickness rotator cuff tears ranges from 5-40%, with an increasing incidence of cuff pathology in advanced age. (medscape.com)
  • Cadaveric studies by Bigliani et al found that 39% of individuals older than 60 years had full-thickness rotator cuff tears with an even higher incidence of partial tears. (medscape.com)
  • He specializes in arthroscopic and open treatment of shoulder and elbow conditions, including shoulder arthritis, rotator cuff tears, fractures, and instability. (bostonssc.com)
  • He has a particular focus in complex problems of the shoulder requiring shoulder replacement, sports related injuries, shoulder instability with bone loss, irreparable tendon tears and failed previous surgery. (bostonssc.com)
  • Dr. Peter Chalmers published a paper entitled, "Rotator cuff muscle imbalance associates with shoulder instability direction" in the Journal of Shoulder and Elbow Surgery. (chalmersmd.com)
  • Dr. Peter Chalmers presented on "Case-Based Approach to Managing Complex Shoulder Problems in the Young Adult: Arthritis, Irreparable Rotator Cuff, and Recurrent Instability" at the American Orthopaedic Society for Sports Medical in Colorado Springs, CO. (chalmersmd.com)
  • or, a surgeon can perform a debridement (trimming or smoothing the tendon) in the case of a partial tear. (kcorthopedics.com)
  • The LDT involves the transfer of the latissimus dorsi tendon from its original insertion to the greater tuberosity, which converts the latissimus dorsi into an external rotator and a flexor of the glenohumeral joint [10]. (fortuneonline.org)
  • Discussion and conclusion: Functional repair of the infraspinatus, leaving the greater tuberosity uncovered, in patients with irreparable cuff tears gives good results in terms of patient satisfaction and in restoring the AHD even at long-term follow-up. (nosokoma247.gr)
  • A labral tear can cause problems with stability and mobility, as well as pain. (kcorthopedics.com)
  • Moreover, the teres major transfer (TMT) has also been described both in isolation and in conjunction with the LDT, as well as pectoralis major and pectoralis minor transfers [10]. (fortuneonline.org)
  • 1] Others would regard it as futile effort to try and mobilize such tendons and resort to tendon transfers (pectoralis major for subscapularis tears and latissimus dorsi for posterosuperior tears). (internationalshoulderjournal.org)
  • Tendon transfers are used very sparingly, the most commonly done being pectoralis major transfer for irreparable tears of the subscapularis muscle tendon. (internationalshoulderjournal.org)
  • They represent a spectrum of disease, ranging from acute reversible tendinitis to massive tears involving the supraspinatus, infraspinatus, and subscapularis. (medscape.com)
  • This study aimed to examine the preliminary clinical results of the infraspinatus rotational transfer procedure for irreparable posterosuperior rotator cuff tears. (cisejournal.org)
  • 15 ] modified and developed a novel surgical procedure from the Japanese literature for irreparable posterosuperior RCTs termed "infraspinatus rotational transfer. (cisejournal.org)
  • They applied this procedure in patients with more severe infraspinatus (ISP) fatty degeneration (n=12) and demonstrated a re-tear rate of 0% after surgery. (cisejournal.org)
  • However, no studies in the English literature have reported the clinical results of infraspinatus rotational transfer (IRT) for irreparable large and massive RCTs. (cisejournal.org)
  • Supraspinatus and infraspinatus atrophy can be observed in massive rotator cuff tears and in entrapments of the suprascapular nerve. (medscape.com)
  • The 4 muscles that make up the rotator cuff are the supraspinatus, the infraspinatus, the subscapularis and the teres minor. (gruttermd.com)
  • Yadoji HK, Bodanki C, Reddy MV, Reddy AV Return to sports and physical activity after a surgical repair of musculotendinous junction tear of supraspinatus. (citizenshospitals.com)
  • Impingement of the deep surface of the supraspinatus tendon on the postero superior glenoid rim: an arthroscopic study. (icr-nice.com)
  • A detailed history is important to diagnose a rotator cuff injury and can help rule out other diagnoses in the differential (eg, referred pain from the cervical spine, more serious referred symptoms of cardiac origin) (see Differential Diagnoses and Other Problems to Be Considered). (medscape.com)
  • BACKGROUND: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. (koreamed.org)
  • BACKGROUND: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. (koreamed.org)
  • The above judgment also varies from surgeon to surgeon: some experienced surgeons would be able to mobilize the tendons arthroscopically to a satisfactory degree and report good results after repair. (internationalshoulderjournal.org)
  • A few experienced surgeons have claimed to observe recovering muscle function after arthroscopic repair of tendons where the muscles seemed to have no potential as judged by conventional imaging. (internationalshoulderjournal.org)
  • A less fortunate indication for this prosthesis is failed cuff repair where the coracoacromial arch has been compromised by surgery and often results in significant pain and poor function. (internationalshoulderjournal.org)
  • At the Cape Shoulder Institute, treatment of massive tears is based on the following protocol: In younger individuals, special effort is made to repair the rotator cuff arthroscopically, often irrespective of the imaging results. (internationalshoulderjournal.org)
  • We do not regard open repair for massive tears as more successful and the latter may even have the complications of impairment of the coracoacromial arch and disastrous results. (internationalshoulderjournal.org)
  • In the older patient with a painful shoulder and large tear, satisfactory results may also be achieved with arthroscopic repair. (internationalshoulderjournal.org)
  • Evaluation of Clinical Outcomes and Inflammatory Markers Between Two Different Suture Anchors in Rotator Cuff Repair. (scotttrenhailemd.com)
  • Long-standing tears may progress to muscle atrophy and fatty degeneration that compromises functional outcome after repair. (gruttermd.com)
  • Surgery for rotator cuff tears typically is done using shoulder arthroscopy (shoulder scope) with rotator cuff repair. (gruttermd.com)
  • Other options include: open rotator cuff repair. (gruttermd.com)
  • Materials and methods: All patients (67 cases) were arthroscopically treated with functional repair of the posterior cuff. (nosokoma247.gr)
  • Complications were rare and in line with the usual sequelae of a rotator cuff repair. (nosokoma247.gr)
  • Saccomanno MF, Sircana G, Cazzato G, Donati F, Randelli P, Milano G. Prognostic factors influencing the outcome of rotator cuff repair: a systematic review. (maristellasaccomanno.com)
  • Chierichini A, Frassanito L, Vergari A, Santoprete S, Chiarotti F, Saccomanno MF, Milano G. The effect of norepinephrine versus epinephrine in irrigation fluid on the incidence of hypotensive/bradycardic events during arthroscopic rotator cuff repair with interscalene block in the sitting position. (maristellasaccomanno.com)
  • Nicholson TA, Kirsch JM, Churchill R, Lazarus MD, Abboud JA, Namdari S. The effect of tranexamic acid for visualization on pump pressure and visualization during arthroscopic rotator cuff repair: an anonymized, randomized controlled trial. (jefferson.edu)
  • Evaluation of Rotator Cuff Repair With and Without Concomitant Biceps Intervention: A Retrospective Review of Patient Outcomes. (jefferson.edu)
  • Sometimes, the rotator cuff in a shoulder can be damaged beyond repair. (kcorthopedics.com)
  • Rotator cuff repair is often done through arthroscopic surgery. (kcorthopedics.com)
  • This is a minimally-invasive way to repair the damage to your rotator cuff. (kcorthopedics.com)
  • Talk to a trained orthopedic surgeon at OSI to learn more about rotator cuff repair and how it may benefit you and give you the improved mobility you deserve. (kcorthopedics.com)
  • Dr. Peter Chalmers presented on "Rotator Cuff Repair: Indications for Surgery" at the Western Orthopaedic Association in Wailea, HI. (chalmersmd.com)
  • Techniques for tendon transfers in the study included both latissimus dorsi transfers and lower trapezius transfers. (massgeneral.org)
  • Mayo Clinic surgeons and scientists collaborate to develop new solutions that improve rotator cuff healing, speed rehabilitation and improve the outcomes for people experiencing shoulder problems. (mayoclinic.org)
  • BACKGROUND: Clinical outcomes and prognosis of large and massive rotator cuff tears are known to be unpredictable not only in degeneration of the rotator cuff, but also due to a. (koreamed.org)
  • In this review, we discuss the indications, biomechanics, open and arthroscopic assisted surgical techniques, and outcomes of LTT for massive irreparable RCTs. (fortuneonline.org)
  • Jon J.P. Warner, PhD , chief of the Shoulder Service at Massachusetts General Hospital, and colleagues compared patient outcomes from both treatments in cases where massive rotators cuff tears were deemed irreparable prior to treatment. (massgeneral.org)
  • Maman E, Kazum E, Abboud JA, Zinger Y, Factor S, Chechik O, Dolkart O. Biodegradable balloon spacer for massive irreparable rotator cuff tears is associated with improved functional outcomes, low revisions, and complications rate at minimum one?year follow-up. (jefferson.edu)
  • BACKGROUND: This study aimed to verify the diagnostic performance of Ultrasonography (US) in the evaluation of fatty infiltration (FI) in rotator cuff muscles and to analyze the diagnostic values of. (koreamed.org)
  • The lower trapezius has a similar line of pull to the posterior rotator muscles and can be transferred with the assistance of a bridging allograft to improve shoulder strength and function. (drandrewmcbride.com)
  • When examining the literature on the viability of the muscles of the torn tendons great variation in opinion is again evident. (internationalshoulderjournal.org)
  • Ligaments, tendon insertion and muscles often cannot withstand high stresses. (heuberer.at)
  • These four muscles rotate and elveate the arm thus the name " rotator cuff . (gruttermd.com)
  • Since the rotator cuff muscle can't function, the design of this implant takes advantage of other muscles - such as the deltoid muscles in the shoulder - to move the arm instead. (kcorthopedics.com)
  • defined an irreparable RCT as an injury where the tendon stump does not reach the footprint after soft tissue mobilization [ 13 ]. (cisejournal.org)
  • Athletes are particularly vulnerable to torn labrums, but anyone who has experienced trauma to the shoulder - such as falling down stairs or getting into a car accident - can suffer from this injury. (kcorthopedics.com)
  • He focuses on primary and revision total shoulder replacements (Reverse and Anatomic), Latarjets, tendon transfers and fractures. (bostonssc.com)
  • 14 ] reported the results of a modified Debeyre-Patte procedure for irreparable large and massive RCTs. (cisejournal.org)
  • We have carried out the IRT procedure to treat irreparable posterosuperior large/massive RCTs since 2018. (cisejournal.org)
  • Often, younger individuals with rotator cuff injuries relate a history of repetitive overhead activities involving the rotator cuff or, less commonly, a history of trauma preceding clinical onset of symptoms. (medscape.com)
  • Moreover, no specific treatment strategies are currently recommended because of the paucity of high-quality clinical studies available for guiding the management of irreparable massive RCTs [ 12 ]. (cisejournal.org)
  • Partners HealthCare System is conducting a clinical research study to evaluate a new investigational device, manufactured by OrthoSpace Ltd., for arthroscopic treatment of massive rotator cuff tears in the shoulder. (bostonshoulderinstitute.com)
  • Scapular winging results in glenoid antetilting, which results in functional elevation of the humeral head and impingement of the rotator cuff. (medscape.com)
  • RESORTHO Balgrist Campus Gerber C, Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff.Clin Orthop Relat Res. (wikipedia.org)
  • There has been controversy regarding the best treatment for irreparable large and massive RCTs. (cisejournal.org)
  • One treatment option involves tendon transfer, which traditionally has involved the latissimus dorsi transfer (LDT). (fortuneonline.org)
  • When a massive irreparable RCT occurs in a young, active patient, tendon transfers represent a viable treatment option [5-8]. (fortuneonline.org)
  • Trenhaile SW, "Massive Cuff Tear: My Treatment Algorithm. (scotttrenhailemd.com)
  • What are the nonoperative treatment options for rotator cuff tears? (gruttermd.com)
  • Non-operative treatment options for rotator cuff tears include: activity modifications, non-steriodal antiinflammatory medications, icing, and physical therapy or a home based shoulder exercise program. (gruttermd.com)
  • The treatment of massive, irreparable rotator cuff tears presents a substantial challenge to health-care professionals. (drmillett.com)
  • The term "massive and irreparable" is difficult to define: are we referring to a mechanical problem where it is impossible for the surgeon to mobilize the tendon of the rotator cuff to its insertion at the tuberosity of the humeral head or to a muscle that has no potential to function even if it were repaired or both. (internationalshoulderjournal.org)
  • Consensus does exist in shoulders with absent cuff function, usually accompanied by anterosuperior subluxation of the humeral head and "pseudo-paralysis" of the shoulder. (internationalshoulderjournal.org)
  • The rotator cuff is a group of four mucsles which originate from the shoulder blade (scapula) and insert as a cuff of tissue around the ball (humeral head) at the top of the bone in the arm called the humerus. (gruttermd.com)
  • The common tendon transfers described for RCTs include the latissimus dorsi transfer (LDT) and the lower trapezius transfer (LTT). (fortuneonline.org)
  • The LDT was first described by L'Episcopo [11] in obstetric brachial plexopathy in 1934 and then utilized for massive irreparable RCTs by Gerber et al. (fortuneonline.org)
  • However, the lower trapezius transfer (LTT) has emerged as an effective alternative with its own set of advantages, such being a tendon transfer that is "in line" and "in phase" with the shoulder functions it restores. (fortuneonline.org)