Massive rotator cuff tears
DOI:
https://doi.org/10.1016/j.rccot.2016.09.007Keywords:
Massive Rotator Cuff Injuries, Rotator Cuff at Risk of Re-rupture, Augmentation SurgeryAbstract
In recent decades, rotator cuff injuries, including massive injuries of it, have become a public health problem because of its high economic impact on health services and labor disabilities caused by these injuries. In general population, the risk of complete rupture is 12%, while in those over 60 years it reaches 48% regardless of symptomatic or asymptomatic presentation of the pathology. To have adequate postoperative scarring of the rotator cuff, many given conditions of bleeding at bone and tendon has to be present as a determining factor on the basis of the biological process of integration. These conditions do not exist in massive injuries as there is a high incidence of osteopenia in the greater tuberosity of the humerus as well as the quality of the remaining tendon tissue is poor, with varying degrees of fatty infiltrates and muscle atrophy, both generating a poor biological environment that favors a large percentage of recurrence. In recent years, the augmentation surgery with biological, synthetic or a combination of both on a stitch placed at the rotator cuff at risk of re-rupture (MRRR) has been promising, supported with a strong theoretical basis in order to achieve a given a biological and mechanical contribution to the compromised rotator cuff tissue.
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