Defined as a tear of the rotator cuff that is greater than 5 centimeters in size or involves a tear of at least 2 of the 4 rotator cuff tendons.
Ten to forty percent of all rotator cuff tears are classified as massive.
Eighty percent of recurrent tears are massive.
Repair of a massive rotator cuff tear has a high failure rate, upwards of 94 percent
High failure rate after surgical repair is contributed to the poor quality of the rotator cuff prior to surgical repair. Massive rotator cuff tears are associated with advanced fatty infiltration of the tendon which is a risk fracture for recurrent tearing.
What is very interesting is that even if the patient has a failed surgical repair of a massive rotator cuff tear their pain will be significantly reduced and their function improved. Anatomical outcome is not associated with functional outcome. This means that even with a recurrent tear after surgery the patients are more functional postoperatively.
Final functional outcomes at mean follow up at approximately 3 years was similar for recurrent tears versus tears that had anatomically healed with surgery in the areas of pain, functional scores and range of motion, according to Drs. Chung et al. as reported in the July 2013 issue of American Journal of Sports Medicine.
Risk factors in sustaining recurrent tears after surgery include patients that are smokers, large tear size preoperatively (greater than 5 centimeters ), and fatty infiltration of the infraspinatinous tendon / muscle that is noted on the preoperative MRI scan.
Leave a Reply
You must be logged in to post a comment.