Management of disorders of the rotator cuff: Proceedings of the ISAKOS upper extremity committee consensus meeting

Guillermo Arce, Klaus Bak, Gregory Bain, Emilio Calvo, Benno Ejnisman, Giovanni Di Giacomo, Vicente Gutierrez, Dan Guttmann, Eiji Itoi, W. Ben Kibler, Tom Ludvigsen, Augustus Mazzocca, Alberto De Castro Pochini, Felix Savoie, Hiroyuki Sugaya, John Uribe, Francisco Vergara, Jaap Willems, Yon Sik Yoo, John W. McNeilMatthew T. Provencher

Research output: Contribution to journalReview articlepeer-review

30 Citations (Scopus)

Abstract

Abstract The goal of this article is to consolidate the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee's (UEC's) current knowledge on rotator cuff disease and management, as well as highlight key unresolved issues. The rotator cuff is an anatomically complex structure important for providing glenohumeral function and stability as part of a closed chain system. Current consensus suggests rotator cuff injuries are most accurately diagnosed, at levels similar to diagnosis by magnetic resonance imaging, with a combination of cuff- and impingement-specific clinical tests. Updates in the understanding of acromion morphology, the insertional anatomy of the rotator cuff, and the role of suprascapular nerve release may require changes to current classification systems and surgical strategies. Although initial management focuses on nonoperative protocols, discussion continues on whether surgery for isolated impingement is clinically more beneficial than rehabilitation. However, clear indications have yet to be established for the use of single- versus double-row repair because evidence confirms neither is clinically efficacious than the other. Biceps tenodesis, however, in non-isolated cuff tears has proven more successful in addressing the etiology of shoulder pain and yields improved outcomes over tenotomy. Data reviewing the benefits of tendon transfers, shoulder prostheses, and mechanical scaffolds, as well as new research on the potential benefit of platelet-rich plasma, pluripotential stem cells, and gene therapies, will also be presented.

Original languageEnglish
Pages (from-to)1840-1850
Number of pages11
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume29
Issue number11
DOIs
Publication statusPublished - 2013 Nov

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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