Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

The decision to select operative versus nonoperative management of rotator cuff tears involves several factors: the age and health of the patient, the size and acuteness of the tear, and the extent of pain and disability. Young and active patients with any size tear are candidates for operative management. Older patients and patients with chronic massive tears may benefit from a course of nonoperative treatment and have less to lose by delaying surgical intervention. (¹) Since Neer's description of impingement lesions in 1972, anterior acromioplasty combined with rotator cuff repair has been the foundation of treatment for full-thickness rotator cuff tears. With the development of arthroscopic techniques, arthroscopic subacromial decompression combined witharthroscopic rotator cuff repair can be considered the treatment of choicefor full-thickness rotator cuff tears. With proper tear pattern recognition, a tension-free rotator cuff repair to bone can be achieved Arthroscopically. (⁸) It is postulated that re-establishing the anatomical configuration of the tendon-bone insertion is a key factor in optimization of this process. Although most techniques may not adequately restore the native footprint area the double-row technique allows nearly 100% coverage. However, the excellent initial mechanical strength and footprint coverage of the double-row technique do not guarantee clinical superiority {u2172}

Issued also as CD