Degenerative Rotator-Cuff Disorders
Abstract
The aim of this review was to present an over view of degenerative rotator cuff tears and a suggested management protocol based upon current evidence. Degenerative rotator cuff tears are common and are a major cause of pain and shoulder dysfunction. The management of these tears is controversial, as to whether they should be managed non-operatively or operatively. In addition when operative intervention is undertaken, there is question as to what technique of repair should be used. This review describes the epidemiology and natural history of degenerative rotator cuff tears. The management options, and the evidence to support these, are reviewed. We also present our preferred management protocol and method, if applicable, for surgical fixation of degenerative rotator cuff tears.
Introduction
The earliest published description of a rotator cuff tear was by Alexander Munro some 220 years ago in 1788, describing a “hole with ragged edges in the capsular ligament of the humerus” [1]. Since this description there has been little agreement amongst orthopaedic surgeons regarding the exact indications for surgical repair of a torn degenerative rotator cuff [2]. The purpose of this review was to present an overview of degenerative rotator cuff tears and a suggested management protocol based upon current evidence.