This case series evaluated medialized rotator cuff repair for chronic retracted posterosuperior tears. When a released tendon will not reach its anatomic footprint, the insertion is shifted medially onto decorticated humeral head cartilage to allow tension-free repair. The authors asked whether this improves function and how often the repair retears.
When you release a chronic retracted tear and the tendon still will not reach the greater tuberosity, anatomic repair under tension sets you up for retear. Medialization is the salvage move: decorticate the humeral head cartilage just medial to the footprint and reattach the tendon there so the repair sits tension-free.
The practical ceiling to remember is roughly 10 mm. Below this, the moment arm and range of motion are largely preserved; beyond it, biomechanical work shows motion starts to suffer. This series also reframes what drives failure. Retear followed tear size, not how far the tendon was retracted or how far it was medialized, so a very large tear should temper your prognosis regardless of technique.
Medialization is a salvage procedure, not a substitute for anatomic repair when the tendon can reach the footprint.
This case series evaluated medialized rotator cuff repair for chronic retracted posterosuperior tears. When a released tendon will not reach its anatomic footprint, the insertion is shifted medially onto decorticated humeral head cartilage to allow tension-free repair. The authors asked whether this improves function and how often the repair retears.
When you release a chronic retracted tear and the tendon still will not reach the greater tuberosity, anatomic repair under tension sets you up for retear. Medialization is the salvage move: decorticate the humeral head cartilage just medial to the footprint and reattach the tendon there so the repair sits tension-free.
The practical ceiling to remember is roughly 10 mm. Below this, the moment arm and range of motion are largely preserved; beyond it, biomechanical work shows motion starts to suffer. This series also reframes what drives failure. Retear followed tear size, not how far the tendon was retracted or how far it was medialized, so a very large tear should temper your prognosis regardless of technique.
Medialization is a salvage procedure, not a substitute for anatomic repair when the tendon can reach the footprint.