Recent studies have reported that massive rotator cuff tears do not heal as predictably as, and may have diminished clinical outcomes compared with, smaller rotator cuff tears. An improved understanding of the biologic degeneration and the biomechanical alterations of massive rotator cuff tears should provide better strategies to optimize outcomes. The approach to patients with massive rotator ...

Introduction The long head of the biceps (LHB) tendon has different loading patterns in its intraand extra-articular regions. The intra-articular region is exposed to complex loads including tension, compression, shear, and frictional forces, while the extra-articular portion is subjected primarily to tensional loads. Previous studies have also shown that the intra-articular region has a more d...

Anthony A. Romeo, MD, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois. B C A A 72-year-old woman presents with chronic shoulder pain subsequent to a fall that has not responded to conservative treatment. She tells you that she “wants it fixed.” T2-weighted coronal (A) and sagittal (B) and T1-weighted sagittal (C) magnetic resonance images are provided. What ...

Purpose and hypothesis: Acromion spur is the extrinsic factor for impingement syndrome and rotator cuff tear. The Rockwood tilt view can be used to evaluate prominence of the anterior acromion, however no study has shown the correlation of findings between the Rockwood tilt view and the arthroscopic finding. METHODS We developed the arthroscopic classification of acromion spur as type 1 flat ...

BACKGROUND The natural history of small, symptomatic rotator cuff tears is currently unclear. The purpose of the present study was to assess the clinical and structural outcomes for a consecutive series of patients with symptomatic, isolated full-thickness supraspinatus tears who had been offered rotator cuff repair but declined operative treatment. METHODS In the study period, twenty-four pa...

Magnetic resonance images of the shoulders of ninety-six asymptomatic individuals were evaluated to determine the prevalence of findings consistent with a tear of the rotator cuff. The scans were reviewed independently by two diagnostic radiologists who are experienced in the interpretation of magnetic resonance images of the shoulder. The over-all prevalence of tears of the rotator cuff in all...

BACKGROUND Chronic rotator cuff tears are a common source of shoulder pain and disability, and patients with chronic cuff tears often have substantial weakness, fibrosis, inflammation, and fat accumulation. Identifying therapies to prevent the development of these pathologic processes will likely have a positive impact on clinical outcomes. Simvastatin is a drug with demonstrated anti-inflammat...

BACKGROUND Redundancies in the rotator cuff tissue, commonly referred to as "dog ear" deformities, are frequently encountered during rotator cuff repair. Knowledge of how these deformities are created and their impact on rotator cuff footprint restoration is limited. PURPOSE The goals of this study were to assess the impact of tear size and repair method on the creation and management of dog ...

Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology. The majority of literature on ACJ cysts consists of individual case reports with no definitive literature review currently available. In addition to a comprehensive literature review, four clinical cases are presented in this report. First described by Craig (1984), a total of 41 ca...

Arthroscopic rotator cuff repair is being performed by an increasing number of orthopaedic surgeons. The principles, techniques, and instrumentation have evolved to the extent that all patterns and sizes of rotator cuff tear, including massive tears, can now be repaired arthroscopically. Achieving a biomechanically stable construct is critical to biologic healing. The ideal repair construct mus...