Management of rotator cuff tears
Click here to see the new Rotator Cuff Book Optimizing the Management of Full-Thickness Rotator Cuff Tears This article proposes a formula for determining the appropriateness of different approaches to the patient with a rotator cuff defect using "appropriate use criteria". Importantly the authors emphasize some of the 4Ps. The problem is characterized in terms of the tear size, retraction, and atrophy/fatty infiltration as well as the severity of pain The patient is characterized in terms of - the American Society of Anesthesiologist classification of the amount of systemic disease, - factors that negatively affect healing (for example: diabetes, obesity, osteoporosis, prior infection, advanced age, smoking, multiple cortisone injections, use of predisone or immunosupressive drugs, and Parkinson's disease) - factors that negatively affect outcome (for example: worker's compensation, litigation, substance abuse, psychiatric disorders) The procedures ...