Massive Rotator Cuff Tears

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.

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.

This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty.

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.

A valuable collection of up-to-date information by leading international experts The history of rotator cuff tendinopathy started more than 150 years ago, when some types of shoulder pain were attributed to rupture of the rotator cuff tendon'. In the third millennium, the pathogenetic mechanisms leading to rotator cuff problems are still debated. Although conservative measures are the first-line therapy, poor spontaneous tendon healing and progression from partial- thickness to full-thickness tears may mandate surgery. Biological, biomechanical and clinical studies have been conducted to establish the superiority of one technique over the other, but no clinical differences have been found. Although we know more about the pathogenesis, diagnosis and management of rotator cuff pathology, our efforts should be directed at trying to find the treatment that best fits the specific needs of each patient. This book collects current reviews on rotator cuff problems, with regard to both biological and clinical aspects, and provides practical hints on management and rehabilitation for sports physicians, surgeons, physiotherapists and athletic trainers.

This book presents the consensus findings of the ISAKOS Shoulder Committee regarding the treatment options in patients suffering from shoulder pain and reduced function or dead arm syndrome as a consequence of rotator cuff injuries. The aim is twofold: to equip readers with a precise knowledge of the presenting characteristics of these injuries in different age groups and to describe in detail the initial management and surgical and non-surgical approaches, taking into account the age-specific features. Readers will find clear descriptions of all the latest arthroscopic techniques, which allow repair of even the largest tears. The indications for and performance of tendon transfer procedures, biceps tenotomy, tenodesis, hemiarthroplasty, anatomic shoulder arthroplasty, reverse total shoulder arthroplasty, and revision surgery are explained. Helpful guidance is also provided on the use of strategies to promote rotator cuff healing, including stem cell therapy and scaffolds. The authors are leading experts in the field, and the book will be of value for all shoulder surgeons and orthopaedic trainees and consultants, as well as sports medicine specialists.

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.

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.