医学
肩袖
眼泪
保守管理
病因学
磁共振成像
自然史
模式
外科
重症监护医学
作者
Kevin D. Plancher,Jaya Shanmugam,Karen Briggs,Stephanie C Petterson
出处
期刊:Journal of the American Academy of Orthopaedic Surgeons
[American Academy of Orthopaedic Surgeons]
日期:2021-12-15
卷期号:29 (24): 1031-1043
标识
DOI:10.5435/jaaos-d-20-01092
摘要
Partial thickness rotator cuff tears (PRCTs) are a challenging disease entity. Optimal management of PRCTs continues to be controversial. Although advances in magnetic resonance imaging and ultrasonography have aided in early diagnosis, arthroscopic evaluation remains the benchmark for diagnosis. Conservative treatment is often the first line of management for most patients; however, evidence suggests that surgical intervention may limit tear progression and the long-term sequelae. Surgical decision making is driven by factors such as age, arm dominance, etiology, activity level, tear thickness, and tear location. Many surgical options have been described in the literature to treat PRCTs including arthroscopic débridement, transosseous, in situ repair techniques, and tear completion and repair. Biologic supplements have also become an attractive alternative to aid in healing; however, the long-term efficacy of these modalities is largely unknown. This article will provide a detailed review of the etiology and natural history of PRCTs, as well as diagnosis, and current management to guide clinical decision-making and formulate an algorithm for management of PRCTs for the orthopaedic surgeon.
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