The coracoacromial ligament (CAL) was first described as a pain generator by Dr Charles Neer in the early 1970s. Since that time, considerable controversy regarding CAL management during acromioplasty has persisted. This review aims to better understand the role of the CAL in shoulder physiology and pathology. Sixty-six articles from 1958 to 2016 were identified using an electronic search of Pu...

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 ...

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...

BACKGROUND For many orthopaedic disorders, symptoms correlate with disease severity. The objective of this study was to determine if pain level is related to the severity of rotator cuff disorders. METHODS A cohort of 393 subjects with an atraumatic symptomatic full-thickness rotator-cuff tear treated with physical therapy was studied. Baseline pretreatment data were used to examine the relat...

BACKGROUND AND PURPOSE Why some full-thickness rotator cuff tears are symptomatic and others are asymptomatic is not understood. By comparing MRI findings in symptomatic and asymptomatic tears, we wanted to identify any tear characteristics that differed between groups. PATIENTS AND METHODS 50 subjects with asymptomatic and 50 subjects with symptomatic full-thickness tears were examined by MR...