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11. Advances in the Treatment of Rotator Cuff Tears: Management of Rotator Cuff Tears in the Athlete

Author

Reinholz, Anna K., Till, Sara E., Arguello, Alexandra M., Barlow, Jonathan D., Okoroha, Kelechi R., and Camp, Christopher L.

Subjects
Arthroscopy, Rotator Cuff, Treatment Outcome, Athletes, Humans, Article, Rotator Cuff Injuries
Abstract

Treatment of rotator cuff tears in the athlete depends on several patient-specific factors, injury characteristics, and surgeon preference; however the overarching goal of treatment is keep athletes playing at a their desired level for as long as possible. Prevention of these injuries and rehabilitation after they occur depend on maintenance of proper throwing mechanics, assessment of the entire kinetic chain, and an evidence-based multiphasic physical therapy regimen. There is a paucity of data reporting the outcomes of surgical treatment of rotator cuff tears in overhead athletes, but the data that is available demonstrates a very guarded prognosis. Accordingly, nonoperative management is the gold standard treatment in the young athlete, particularly for throwers. If this non-operative treatment is unsuccessful, arthroscopic debridement and formal repair are surgical options to consider. In throwers, debridement is generally used for tears that involve up to 75% of the footprint thickness. For full thickness tears or those involving > 75% of the footprint, formal repair using a double row technique with a lateralized footprint is typically utilized. Given the relatively poor outcomes of surgical treatment, these cases require a very frank discussion about the nature of the injury, all treatment options, athletic goals, and the anticipated outcomes.

Published
2023

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