Rotator cuff tears are among the most common conditions affecting the shoulder. Despite their ubiquity, however, there is substantial debate concerning their management. Partial and complete rotator cuff tears are known to occur with increasing frequency with increasing age in asymptomatic people1-3. The clinical results of rotator cuff repair in symptomatic patients who have been followed for as long as 10 years are good to excellent in a high percentage of cases, even though rerupture of the cuff is known to occur 20% to 65% of the time4-7. Moreover, the presence of a massive, irreparable rotator cuff tear is not incompatible with good overhead function8. These observations have traditionally made clinical decision-making in the treatment of symptomatic rotator cuff tears difficult. Historically, treatment recommendations have included rehabilitation, surgical repair, subacromial decompression without repair, tendon transfers, and tendon substitution techniques6,8-21.
Controversy regarding the management of patients with symptomatic, full-thickness rotator cuff tears is largely the result of the heterogeneity of the patient population and the dearth of well-controlled comparative data. Much progress toward a more unified understanding of the surgical indications and outcomes of rotator cuff repair has been made in recent years, although there is still considerable confusion. The purposes of this symposium are to review the history and current controversies of rotator cuff tears and their management, to outline the indications and outcomes of both nonoperative management and surgical repair of rotator cuff tears, and to summarize the surgical options and outcomes in patients with irreparable rotator cuff tears.
### Rotator Cuff Injury
Injuries of the rotator cuff have been known to occur since the earliest of medical writings. A description of a rotator cuff injury appeared in Edwin Smith's Surgical Papyrus, one of the oldest known …
Copyright remains with the authors and publisher.
Rotator cuff tears are among the most common conditions affecting the shoulder. Despite their ubiquity, however, there is substantial debate concerning their management. Partial and complete rotator cuff tears are known to occur with increasing frequency with increasing age in asymptomatic people1-3. The clinical results of rotator cuff repair in symptomatic patients who have been followed for as long as 10 years are good to excellent in a high percentage of cases, even though rerupture of the cuff is known to occur 20% to 65% of the time4-7. Moreover, the presence of a massive, irreparable rotator cuff tear is not incompatible with good overhead function8. These observations have traditionally made clinical decision-making in the treatment of symptomatic rotator cuff tears difficult. Historically, treatment recommendations have included rehabilitation, surgical repair, subacromial decompression without repair, tendon transfers, and tendon substitution techniques6,8-21.
Controversy regarding the management of patients with symptomatic, full-thickness rotator cuff tears is largely the result of the heterogeneity of the patient population and the dearth of well-controlled comparative data. Much progress toward a more unified understanding of the surgical indications and outcomes of rotator cuff repair has been made in recent years, although there is still considerable confusion. The purposes of this symposium are to review the history and current controversies of rotator cuff tears and their management, to outline the indications and outcomes of both nonoperative management and surgical repair of rotator cuff tears, and to summarize the surgical options and outcomes in patients with irreparable rotator cuff tears.
### Rotator Cuff Injury
Injuries of the rotator cuff have been known to occur since the earliest of medical writings. A description of a rotator cuff injury appeared in Edwin Smith's Surgical Papyrus, one of the oldest known …
Copyright remains with the authors and publisher.