The Journal of Bone and Joint Surgery (American). 2004;86:2764-2776
© 2004 The Journal of Bone and Joint Surgery, Inc.
Rotator Cuff Tears: Why Do We Repair Them?*
Gerald R. Williams, Jr., MD1,
Charles A. Rockwood, Jr., MD2,
Louis U. Bigliani, MD3,
Joseph P. Iannotti, MD, PhD4 and
Walter Stanwood, MD3
1 Presbyterian Hospital, 39th and Market Streets, 1 Cupp Pavilion, Philadelphia,
PA 19104. E-mail address:
gerald.williams@uphs.upenn.edu
2 Department of Orthopaedic Surgery, University of Texas Health Science Center,
7703 Floyd Curl Drive, San Antonio, TX 78284
3 Department of Orthopaedic Surgery, Columbia University-Presbyterian Medical
Center, 622 West 168th Street, PH-11th Floor, New York, NY 10032
4 Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid
Avenue, Cleveland, OH 44195
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Introduction
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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 ten 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 . . . [Full Text of this Article]

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