Massive And Irreparable Rotator Cuff Tears

This book offers a truly comprehensive overview of the understanding and treatment of massive and irreparable rotator cuff tears, a painful and disabling shoulder condition that continues to pose major challenges. A thorough examination of basic science issues and evidence lays the foundation for discussion of key controversies in the field and exposition of a practical approach to treatment in which the role of both conservative and surgical management is explained. Special insights are provided into the new biological and nonoperative approaches that are becoming increasingly popular among practitioners. All potential surgical techniques are described, from partial repair and tendon transfer, to the use of dedicated implants. In addition, the value of anesthesia and regional blocks, both during surgery and in the postoperative phase, is discussed. The concluding section addresses particularly complex scenarios and offers guidance on the management of treatment complications and failures. Written by leading international shoulder experts, the book will be of value for shoulder surgeons, rehabilitators, and other health care practitioners.

Evidence-Based Orthopedics is an up-to-date review of the best evidence for the diagnosis, management, and treatment of orthopedic conditions. Covering orthopedic surgery as well as pre- and post-operative complications, this comprehensive guide provides recommendations for implementing evidence-based practice in the clinical setting. Chapters written by leading clinicians and researchers in the field are supported by tables of evidence that summarize systematic reviews and randomized controlled trials. In areas where evidence is insufficient to recommend a practice, summaries of the available research are provided to assist in decision-making. This fully revised new edition reflects the most recent evidence using the approved evidence-based medicine (EBM) guidelines and methodology. The text now places greater emphasis on GRADE—a transparent framework for developing and presenting summaries of evidence—to allow readers to easily evaluate the quality of evidence and the strength of recommendations. The second edition offers a streamlined presentation and an improved standardized format emphasizing how evidence in each chapter directly affects clinical decisions. Incorporating a vast amount of new evidence, Evidence-Based Orthopedics: Features thoroughly revised and updated content, including a new chapter on pediatric orthopedics and new X-ray images Provides the evidence base for orthopedic surgery as well as pediatric orthopedics and orthopedic conditions requiring medical treatment Covers the different methods for most orthopedic surgical procedures, such as hip replacements, arthroscopy, and knee replacements Helps surgeons and orthopedic specialists achieve a uniform optimum standard through a condition-based approach Aligns with internationally accepted guidelines and best health economic principles Evidence-Based Orthopedics is an invaluable resource for orthopedic specialists, surgeons, trauma surgeons, trainees, and medical students.

This book is exceptional in providing detailed state of the art guidance on all aspects of transfer of the latissimus dorsi tendon for indications including irreparable posterosuperior rotator cuff tears, irreparable subscapularis tears, and shoulder replacement. In addition to clear, well-illustrated descriptions of arthroscopically assisted surgical technique, readers will find helpful information on biomechanics, surgical indications, post-transfer rehabilitation, and complications and their management. Outcomes from individual studies and meta-analyses are evaluated, and a feature of special interest is the presentation of experiences and results in a series of more than 430 patients using the surgical technique first described by Enrico Gervasi more than 10 years ago. This technique involves modifications in both preparation of the footprint for the latissimus dorsi tendon and the biomechanical features of the tendon transfer and is very different from the procedure proposed by Christian Gerber. The book will be of high value for all orthopedic surgeons who perform this complex shoulder surgery, as well as for residents and fellows-in-training.

Focusing exclusively on reverse shoulder arthroplasty (RSA) techniques and devices, this plentifully illustrated text covers all aspects of this important and innovative treatment for shoulder pain and dysfunction. The book begins with a history of RSA followed by a thorough overview of the basic science and biomechanics of the shoulder. Indications for and clinical applications of RSA in a number of surgical interventions are then described, including the revision of failed shoulder arthroplasty, setting in cases of glenoid and humeral bone loss and rotator cuff tears. A whole section is then dedicated to various commercial devices with descriptive expert analysis of the design and implementation of each. An examination of the current economic value of RSA, including cost effectiveness and expected cost outcomes, comprises the final section. Reverse Shoulder Arthroplasty can therefore be read either from start to finish, allowing orthopedic surgeons to appreciate the various perspectives offered, or by selecting specific topics of interest much like a “how-to manual” of either a particular device design or the treatment of a specific pathology.

Presenting a logical, comprehensive approach to the patient with a massive rotator cuff tear, this book begins with the pathoanatomy and diagnostic work-up for this common injury, including imaging. Both non-operative and operative treatment options for massive tears follow, including arthroscopy, the use of biologics and patches, tendon transfers, and hemiarthroplasty and reverse total shoulder arthroplasty. A practical treatment algorithm for clinicians treating patients with massive rotator cuff tears is also included. Each chapter opens with pearls and pitfalls covering the main key points for quick reference. The overarching theme of this book is that patients with similar imaging findings may demonstrate very different clinical presentations, and the final treatment recommendation should be made based on their complaints and expectations. As such, it will be an excellent resource for orthopedic surgeons, sports medicine and shoulder physicians, physiatrists, physical medicine and rehab specialists, and occupational therapists.

In this issue of Clinics in Sports Medicine, Dr. Stephen Brockmeier from the University of Virginia has assembled a group of experts to provide the latest updates on Rotator Cuff Surgery. This issue begins with the epidemiology and natural history of rotator cuff tears, followed by articles on: Imaging Evaluation of the Rotator Cuff; Arthroscopic Rotator Cuff Repair: Techniques in 2012; Biologics in the Management of Rotator Cuff Surgery; Outcomes of Rotator Cuff Surgery: What Does the Evidence Tell Us?; Rotator Cuff Injury in the Overhead Athlete; Failed Rotator Cuff Surgery, Evaluation and Decision-Making; Revision Rotator Cuff Repair; Non-Arthroplasty Options for the Management of Massive and Irreparable Rotator Cuff Tears; and Reverse Total Shoulder Arthroplasty for Irreparable Rotator Cuff Tears and Cuff Tear Arthroplasty.

This handbook fully investigates reverse shoulder arthroplasty (RSA), presenting all the recent advances in the field to enable shoulder surgeons to treat patients with complex conditions, such as rotator cuff tears and instability, failed surgery and combined arthritis, or proximal humerus neoplasia. Reverse shoulder arthroplasty is becoming increasingly common because conventional total shoulder replacement may cause pain, loss of strength, simple or complex disabilities as well as limited motion, reducing general quality of life. The goal of a reverse prosthesis is to restore a painless, biomechanically valid joint. Drawing on the results of recent studies, the book covers all relevant aspects of RSA, including basic science, pathogenesis, clinical and instrumental evaluation, surgical techniques and complication management, helping readers to better understand when and how reverse shoulder arthroplasty should be implanted and what to do in cases of poor results. Written by leading shoulder specialists, the book provides surgeons and rehabilitation specialists, as well as residents and shoulder fellows, with a valuable, state-of-the-art guide for clinical practice.

Fundamentals in rotator cuff repair and reconstruction from world-renowned experts! Rotator cuff disorders are the most common cause of shoulder pain, accounting for up to 70% of cases. Tears are the most severe subtype, with a lifetime prevalence rate of more than 20%. The size, location, and severity of rotator cuff tears varies greatly, requiring equally diverse preoperative planning and surgical interventions. Video Atlas of Arthroscopic Rotator Cuff Repair by Uma Srikumaran and esteemed contributors provides a concise, well-rounded perspective on the surgical management of rotator cuff pathologies. Expert surgeons from across the globe describe and demonstrate numerous approaches, enabling clinicians to expand their armamentarium and achieve optimal outcomes. The opening chapters lay a solid foundation, covering basic techniques for arthroscopic repair of various rotator cuff tear patterns, patient positioning, portal placement, tips and tricks, complications, and pitfalls. Subsequent chapters succinctly discuss a comprehensive range of arthroscopic and transosseous techniques, biologic augmentation, grafting, tendon transfers, and superior capsular reconstruction. Key Features Easy-to-digest bulleted format and narrated step-by-step videos on diverse techniques Discussion of different core procedures to manage rotator cuff tears, biceps tendon pathology, as well as failed primary surgeries Videos on superior capsule reconstruction and lower trap tendon transfer narrated by the technique creators Varied perspectives on the controversial topic of how to manage massive and irreparable tears This is a must-have resource for orthopaedic surgery residents and fellows, especially shoulder and sports injury specialists.