ࡱ > 1 0 3
! " # $ % & ' ( ) * + , - . / K bjbj,(,( NB NB B
8
8
4 R R R h L R u D + + + +
- f p- $ - /u 1u 1u 1u 1u 1u 1u , x `{ V ]u - -
-
- - - ]u VZ + + 4 u VZ VZ VZ - # + + g >
VZ - /u VZ VZ \ \ 0x Q \ g u 0 u \ { VZ { ] VZ ] \ e] x
- - - ]u ]u VZ - - - u { - - - - - - - - - N
:
Name of Journal: World Journal of Orthopedics
ESPS Manuscript NO: 17163
ManuscriptType: EDITORIAL
Treatment options for irreparable postero-superior cuff tears in young patients
Galasso O et al. Irreparable cuff tears in young patients
Olimpio Galasso, Filippo Familiari, Giorgio Gasparini
Olimpio Galasso, Filippo Familiari, Giorgio Gasparini, Department of Orthopaedic and Trauma Surgery, Magna Grcia University of Catanzaro, 88100 Catanzaro, Italy
Author contributions: Galasso O, Familiari F, and Gasparini G contributed evenly to this paper.
Conflict-of-interest statement: The authors did not receive any funding or grants in support of their research for or preparation of this work. The authors declare no conflict of interest.
Open-Access: This article is an open-accessarticlewhich was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributedinaccordancewith the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: HYPERLINK "http://creativecommons.org/licenses/by-nc/4.0/" http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Filippo Familiari, MD, Department of Orthopaedic and Trauma Surgery, Magna Grcia University of Catanzaro, Campus S.Venuta, V.le Europa (Loc. Germaneto), 88100 Catanzaro, Italy. HYPERLINK "mailto:ehenze1@jhmi.edu" filippofamiliari@gmail.com
Telephone: +39-0961-3647001
Fax: +39-0961-3647104
Received: February 21, 2015
Peer-review started: February 22, 2015
First decision: July 10, 2015
Revised: September 7, 2015
Accepted: September 25, 2015
Article in press:
Published online:
Abstract
Rotator cuff tears (RCTs) occur more commonly with advanced age, with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs. Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10%, and the incidence of irreparable RCTs in young patients is still unknown. Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse shoulder arthroplasty. After being thoroughly investigated in open surgery, arthroscopic techniques for latissimus dorsi tendon transfer have been recently described. They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.
Key words: Postero-superior rotator cuff tears; Irreparable; Young patients; Latissimus dorsi; Tendon transfer
The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Core tip: Irreparable postero-superior cuff tears have been reported as frequent as 7% to 10%, and they are challenging, especially in young and active patients. In this patient population, the number of therapeutic options dramatically decreases. Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse total shoulder arthroplasty. Latissimus dorsi tendon transfer seems to be a viable option to restore function and decrease pain in young and active patients.
Galasso O, Familiari F, Gasparini G. Treatment options for irreparable postero-superior cuff tears in young patients. World J Orthop 2015; In press
INTRODUCTION
Rotator cuff tears (RCTs) occur more frequently in elderlies, with asymptomatic tears reported in up to 54% of patients aged > 60 years ADDIN EN.CITE ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_1" \o "Omid, 2013 #944" 1, HYPERLINK \l "_ENREF_2" \o "Sher, 1995 #982" 2]. Degenerative tears are more common in the older patient population, whereas more variability can be found in a younger population ADDIN EN.CITE Burns2008998[3]99899817Burns, J. P.Snyder, S. J.The Southern California Orthopedic Institute, Van Nuys, CA, USA.Arthroscopic rotator cuff repair in patients younger than fifty years of ageJ Shoulder Elbow SurgJournal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]J Shoulder Elbow SurgJournal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]J Shoulder Elbow SurgJournal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]90-6171AdultArthroscopyFemaleHumansMaleMiddle AgedRange of Motion, ArticularRotator Cuff/*surgeryRuptureShoulder Joint/physiopathologyTreatment Outcome2008Jan-Feb1532-6500 (Electronic)
1058-2746 (Linking)18069008http://www.ncbi.nlm.nih.gov/pubmed/1806900810.1016/j.jse.2007.05.006[ HYPERLINK \l "_ENREF_3" \o "Burns, 2008 #998" 3]. In patients 30 years old or younger, rotator cuff tendons are generally healthy, robust, and less likely to be the source of symptoms ADDIN EN.CITE Bishay984[4]98498417Bishay, V.Gallo, R. A.Prim, CareDepartment of Family Medicine, Mount Sinai Hospital, 1500 South California Avenue, Chicago, IL 60608, USA. Electronic address: rgallo@hmc.psu.edu. FAU - Gallo, Robert AThe evaluation and treatment of rotator cuff pathology1558-299X (Electronic)201311112013 Deceng[ HYPERLINK \l "_ENREF_4" \o "Bishay, #984" 4]. Nevertheless, this patient population can be affected by degenerative tears, partial tears of the articular (PASTA lesions), partial tears of the bursal side, full-thickness tears and lesions secondary to calcium deposits. Eventhough the occurrence of an irreparable RCT is an infrequent condition in young individuals, it represents a significant challenge to the orthopedic and rehabilitation coomunity.
For shoulder arthroplasty patients, young has been arbitrarily defined as younger than 55 years ADDIN EN.CITE ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_5" \o "Johnson, 2015 #999" 5, HYPERLINK \l "_ENREF_6" \o "Tibbetts, 2011 #1000" 6], and no clear definition has been made for rotator cuff patients. After open rotator cuff repair, younger patients (< 55 years of age) have been found 3.5 times l e s s s a t i s f i e d t h a n o l d e r p a t i e n t s ( e" 5 5 y e a r s o f a g e ) A D D I N E N . C I T E <