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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 April;62(2):89-108
An evidence-based review of the etiology, classification, diagnosis, and treatment of rotator cuff tears
Ellman M. B., Gregory J. M., Bhatia S., Hsu A., Ghodadra N., Provencher M. T., Romeo A. A.
1 Division of Sports Medicine, Department of Orthopedic Surgery, RUSH University Medical, Chicago, IL, USA
2 Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, CA
Pathologic changes in the rotator cuff occur on a continuum from tendinitis to tears. Over the past decade, there have been numerous advances in the understanding and treatment of rotator cuff disease with a concurrent rise in the number of rotator cuff repairs performed by orthopedic surgeons. Nevertheless, several aspects of rotator cuff disease, including the natural history, progression, treatment options, and optimal repair constructs, remain widely debated in the literature. In this review, the numerous aspects of rotator cuff tears, from etiology and natural history to classification, diagnosis and treatment are discussed in detail. Treatment should be based on the patient’s goals, etiology, and depth of the tear, rather than imaging findings alone. The indications for nonoperative versus operative management are provided, as are the numerous treatment options for surgical repair of both partial and full-thickness rotator cuff tears.