Fukuda (2000) — delivered as the Codman Lecture at the 1998 International Conference on Surgery of the Shoulder — compares Codman's original observations on rotator cuff tears with contemporary clinical, histologic, and molecular data, asking what has changed and what Codman got right. The paper focuses on partial-thickness supraspinatus tears: their classification, pain biology, natural history, diagnostic imaging, pathogenesis, and surgical outcomes.
When you identify a partial-thickness rotator cuff tear, don't assume it's less serious than a full-thickness tear — it likely hurts more and has an 80% chance of enlarging or converting to full-thickness without intervention.
Tear subtype drives treatment: bursal-side tears are more painful, more often associated with impingement, and warrant earlier surgical consideration, while joint-side tears may be trialed with conservative management first.
Fukuda (2000) — delivered as the Codman Lecture at the 1998 International Conference on Surgery of the Shoulder — compares Codman's original observations on rotator cuff tears with contemporary clinical, histologic, and molecular data, asking what has changed and what Codman got right. The paper focuses on partial-thickness supraspinatus tears: their classification, pain biology, natural history, diagnostic imaging, pathogenesis, and surgical outcomes.
When you identify a partial-thickness rotator cuff tear, don't assume it's less serious than a full-thickness tear — it likely hurts more and has an 80% chance of enlarging or converting to full-thickness without intervention.
Tear subtype drives treatment: bursal-side tears are more painful, more often associated with impingement, and warrant earlier surgical consideration, while joint-side tears may be trialed with conservative management first.