nach oben

Current Reviews in Musculoskeletal Medicine

Erschienen in:

13.01.2018 | Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

verfasst von: Joseph N. Liu, Grant H. Garcia, Anirudh K. Gowd, Brandon C. Cabarcas, Michael D. Charles, Anthony A. Romeo, Nikhil N. Verma

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears.

Recent Findings

Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best.

Summary

Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid. The true prevalence of partial tears may be underestimated given the high incidence of asymptomatic tears. Both dynamic ultrasound and enhanced contrast MRI have improved our understanding of this pathology. For most overhead athletes, nonoperative management is the most common course. Despite advances in imaging, diagnosis, and surgical techniques, our ability to return these patients to their elite level is modest at best when nonoperative management fails and surgical treatment is performed. If a surgical route is needed, debridement alone is the most frequent procedure given concerns of over constraint and poor return to play with surgical repair of the partial thickness rotator cuff tear.

Connor PM, Banks DM, Tyson AB, Coumas JS, D'Alessandro DF. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med. 2003;31(5):724–7. https://doi.org/10.1177/03635465030310051501.CrossRefPubMed

Conway JE. Arthroscopic repair of partial-thickness rotator cuff tears and SLAP lesions in professional baseball players. Orthop Clin N Am. 2001;32(3):443–56. https://doi.org/10.1016/S0030-5898(05)70213-3.CrossRef

Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–20. https://doi.org/10.1053/jars.2003.50128.CrossRefPubMed

McFarland EG, Wasik M. Epidemiology of collegiate baseball injuries. Clin J Sport Med. 1998;8(1):10–3. https://doi.org/10.1097/00042752-199801000-00003.CrossRefPubMed

• Del Grande F, Aro M, Jalali Farahani S, Cosgarea A, Wilckens J, Carrino JA. High-resolution 3-T magnetic resonance imaging of the shoulder in nonsymptomatic professional baseball pitcher draft picks. J Comput Assist Tomogr. 2016;40(1):118–25. Study demonstrating high incidence of tendinopathy and partial tears in asymptomatic baseball players. https://doi.org/10.1097/RCT.0000000000000327.

Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 2004;86-A(4):708–16.CrossRefPubMed

Miniaci A, Mascia AT, Salonen DC, Becker EJ. Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med. 2002;30(1):66–73. https://doi.org/10.1177/03635465020300012501.CrossRefPubMed

Lesniak BP, Baraga MG, Jose J, Smith MK, Cunningham S, Kaplan LD. Glenohumeral findings on magnetic resonance imaging correlate with innings pitched in asymptomatic pitchers. Am J Sports Med. 2013;41(9):2022–7. https://doi.org/10.1177/0363546513491093.CrossRefPubMed

• Dines JS, Jones K, Maher P, Altchek D. Arthroscopic management of full-thickness rotator cuff tears in Major League Baseball pitchers: the lateralized footprint repair technique. Am J Orthop (Belle Mead NJ). 2016;45(3):128–33. Case series describing high rate of return to sport for professional baseball pitchers after surgical repair of full-thickness rotator cuff tears using lateralized footprint repair technique.

10.

Brockmeier SF, Dodson CC, Gamradt SC, Coleman SH, Altchek DW. Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes. Arthroscopy. 2008;24(8):961–5. https://doi.org/10.1016/j.arthro.2007.08.016.CrossRefPubMed

11.

Liem D, Lichtenberg S, Magosch P, Habermeyer P. Arthroscopic rotator cuff repair in overhead-throwing athletes. Am J Sports Med. 2008;36(7):1317–22. https://doi.org/10.1177/0363546508314794.CrossRefPubMed

12.

Mazoue CG, Andrews JR. Repair of full-thickness rotator cuff tears in professional baseball players. Am J Sports Med. 2006;34(2):182–9. https://doi.org/10.1177/0363546505279916.CrossRefPubMed

13.

Reynolds SB, Dugas JR, Cain EL, McMichael CS, Andrews JR. Debridement of small partial-thickness rotator cuff tears in elite overhead throwers. Clin Orthop Relat Res. 2008;466(3):614–21. https://doi.org/10.1007/s11999-007-0107-1.CrossRefPubMedPubMedCentral

14.

Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G. Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy. 1991;7(1):1–7. https://doi.org/10.1016/0749-8063(91)90070-E.CrossRefPubMed

15.

Cordasco FA, Backer M, Craig EV, Klein D, Warren RF. The partial-thickness rotator cuff tear: is acromioplasty without repair sufficient? Am J Sports Med. 2002;30(2):257–60. https://doi.org/10.1177/03635465020300021801.CrossRefPubMed

16.

Ide J, Maeda S, Takagi K. Arthroscopic transtendon repair of partial-thickness articular-side tears of the rotator cuff: anatomical and clinical study. Am J Sports Med. 2005;33(11):1672–9. https://doi.org/10.1177/0363546505277141.CrossRefPubMed

17.

Van Kleunen JP, Tucker SA, Field LD, Savoie FH III. Return to high-level throwing after combination infraspinatus repair, SLAP repair, and release of glenohumeral internal rotation deficit. Am J Sports Med. 2012;40(11):2536–41. https://doi.org/10.1177/0363546512459481.CrossRefPubMed

18.

Shaffer B, Huttman D. Rotator cuff tears in the throwing athlete. Sports Med Arthrosc Rev. 2014;22(2):101–9. https://doi.org/10.1097/JSA.0000000000000022.CrossRefPubMed

19.

Andrews JR, Broussard TS, Carson WG. Arthroscopy of the shoulder in the management of partial tears of the rotator cuff: a preliminary report. Arthroscopy. 1985;1(2):117–22. https://doi.org/10.1016/S0749-8063(85)80041-4.CrossRefPubMed

20.

Payne LZ, Altchek DW, Craig EV, Warren RF. Arthroscopic treatment of partial rotator cuff tears in young athletes. A preliminary report. Am J Sports Med. 1997;25(3):299–305. https://doi.org/10.1177/036354659702500305.CrossRefPubMed

21.

CHARLES S, NEER I. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. JBJS. 1972;54(1):41–50.CrossRef

22.

Nho SJ, Yadav H, Shindle MK, MacGillivray JD. Basic science update: rotator cuff degeneration: etiology and pathogenesis. Am J Sports Med. 2008;36(5):987–93. https://doi.org/10.1177/0363546508317344.CrossRefPubMed

23.

Mazzocca AD, Rincon LM, O'Connor RW, Obopilwe E, Andersen M, Geaney L, et al. Intra-articular partial-thickness rotator cuff tears: analysis of injured and repaired strain behavior. Am J Sports Med. 2008;36(1):110–6. https://doi.org/10.1177/0363546507307502.CrossRefPubMed

24.

Lohr JF, Uhthoff HK. The microvascular pattern of the supraspinatus tendon. Clin Orthop Relat Res. 1990;254(254):35–8.

25.

Werner SL, Gill TJ, Murray TA, Cook TD, Hawkins RJ. Relationships between throwing mechanics and shoulder distraction in professional baseball pitchers. Am J Sports Med. 2001;29(3):354–8. https://doi.org/10.1177/03635465010290031701.CrossRefPubMed

26.

Dillman CJ, Fleisig GS, Andrews JR. Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sports Phys Ther. 1993;18(2):402–8. https://doi.org/10.2519/jospt.1993.18.2.402.CrossRefPubMed

27.

Ryu RK, Burkhart SS, Parten PM, Gross RM. Complex topics in arthroscopic subacromial space and rotator cuff surgery. Arthroscopy. 2002;18(2 Suppl 1):51–64. https://doi.org/10.1053/jars.2002.31798.CrossRefPubMed

28.

Kuhn JE, Bey MJ, Huston LJ, Blasier RB, Soslowsky LJ. Ligamentous restraints to external rotation of the humerus in the late-cocking phase of throwing. A cadaveric biomechanical investigation. Am J Sports Med. 2000;28(2):200–5. https://doi.org/10.1177/03635465000280021001.CrossRefPubMed

29.

Rathbun JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg (Br). 1970;52(3):540–53.CrossRef

30.

Jobe CM. Posterior superior glenoid impingement: expanded spectrum. Arthroscopy. 1995;11(5):530–6. https://doi.org/10.1016/0749-8063(95)90128-0.CrossRefPubMed

31.

Jobe FW, Moynes DR, Tibone JE, Perry J. An EMG analysis of the shoulder in pitching. A second report. Am J Sports Med. 1984;12(3):218–20. https://doi.org/10.1177/036354658401200310.CrossRefPubMed

32.

Walch G, Boileau P, Noel E, Donell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elb Surg. 1992;1(5):238–45. https://doi.org/10.1016/S1058-2746(09)80065-7.CrossRef

33.

Codman EA. The shoulder; rupture of the suprasupinatus tendon and other lesions in or about the subacromial bursa. 1934.

34.

Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;254(254):64–74.

35.

Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the management of significant partial-thickness tears of the rotator cuff. Orthop Clin N Am. 1997;28(1):79–82. https://doi.org/10.1016/S0030-5898(05)70266-2.CrossRef

36.

Itoi E, Tabata S. Incomplete rotator cuff tears. Results of operative treatment. Clin Orthop Relat Res. 1992;284(284):128–35.

37.

Matava MJ, Purcell DB, Rudzki JR. Partial-thickness rotator cuff tears. Am J Sports Med. 2005;33(9):1405–17. https://doi.org/10.1177/0363546505280213.CrossRefPubMed

38.

Clark JM, Harryman DT II. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. 1992;74(5):713–25. https://doi.org/10.2106/00004623-199274050-00010.CrossRefPubMed

39.

Fukuda H, Hamada K, Nakajima T, Tomonaga A. Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections. Clin Orthop Relat Res. 1994;304(304):60–7.

40.

Yamanaka K, Matsumoto T. The joint side tear of the rotator cuff. A followup study by arthrography. Clin Orthop Relat Res. 1994;304(304):68–73.

41.

Chalmers PN, Cvetanovich GL, Kupfer N, Wimmer MA, Verma NN, Cole BJ, et al. The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests. J Shoulder Elb Surg. 2016;25(2):322–9. https://doi.org/10.1016/j.jse.2015.07.031.CrossRef

42.

Kibler WB, Sciascia A, Dome D. Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med. 2006;34(10):1643–7. https://doi.org/10.1177/0363546506288728.CrossRefPubMed

43.

Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005;87(7):1446–55. https://doi.org/10.2106/JBJS.D.02335.PubMed

44.

MacDonald PB, Clark P, Sutherland K. An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs. J Shoulder Elb Surg. 2000;9(4):299–301. https://doi.org/10.1067/mse.2000.106918.CrossRef

45.

Blevins FT. Rotator cuff pathology in athletes. Sports Med. 1997;24(3):205–20. https://doi.org/10.2165/00007256-199724030-00009.CrossRefPubMed

46.

Hertel R, Ballmer FT, Lombert SM, Gerber C. Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elb Surg. 1996;5(4):307–13. https://doi.org/10.1016/S1058-2746(96)80058-9.CrossRef

47.

Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD 2nd, Harker P, et al. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med. 2011;39(2):329–35. https://doi.org/10.1177/0363546510384223.CrossRefPubMed

48.

Zaslav KR. Internal rotation resistance strength test: a new diagnostic test to differentiate intra-articular pathology from outlet (Neer) impingement syndrome in the shoulder. J Shoulder Elb Surg. 2001;10(1):23–7. https://doi.org/10.1067/mse.2001.111960.CrossRef

49.

Meister K. Current concepts. Injuries to the shoulder in the throwing athlete. Part two: evaluation/treatment. Am J Sports Med. 2000;28(4):587–601. https://doi.org/10.1177/03635465000280042701.CrossRefPubMed

50.

Hamner DL, Pink MM, Jobe FW. A modification of the relocation test: arthroscopic findings associated with a positive test. J Shoulder Elb Surg. 2000;9(4):263–7. https://doi.org/10.1067/mse.2000.105450.CrossRef

51.

Pearsall AW, Bonsell S, Heitman RJ, Helms CA, Osbahr D, Speer KP. Radiographic findings associated with symptomatic rotator cuff tears. J Shoulder Elb Surg. 2003;12(2):122–7. https://doi.org/10.1067/mse.2003.19.CrossRef

52.

Gartsman GM, Taverna E. The incidence of glenohumeral joint abnormalities associated with full-thickness, reparable rotator cuff tears. Arthroscopy. 1997;13(4):450–5. https://doi.org/10.1016/S0749-8063(97)90123-7.CrossRefPubMed

53.

Gartsman GM, Milne JC. Articular surface partial-thickness rotator cuff tears. J Shoulder Elb Surg. 1995;4(6):409–15. https://doi.org/10.1016/S1058-2746(05)80031-X.CrossRef

54.

Traughber PD, Goodwin TE. Shoulder MRI: arthroscopic correlation with emphasis on partial tears. J Comput Assist Tomogr. 1992;16(1):129–33.PubMed

55.

van Holsbeeck MT, Kolowich PA, Eyler WR, Craig JG, Shirazi KK, Habra GK, et al. US depiction of partial-thickness tear of the rotator cuff. Radiology. 1995;197(2):443–6. https://doi.org/10.1148/radiology.197.2.7480690.CrossRefPubMed

56.

Iannotti JP, Ciccone J, Buss DD, Visotsky JL, Mascha E, Cotman K, et al. Accuracy of office-based ultrasonography of the shoulder for the diagnosis of rotator cuff tears. J Bone Joint Surg Am. 2005;87(6):1305–11. https://doi.org/10.2106/JBJS.D.02100.PubMed

57.

Plate JF, Haubruck P, Walters J, Mannava S, Smith BP, Smith TL, et al. Rotator cuff injuries in professional and recreational athletes. J Surg Orthop Adv. 2013;22(2):134–42. https://doi.org/10.3113/JSOA.2013.0134.CrossRefPubMed

58.

• Reuter S, Imhoff AB, Martetschlager F. Impact of rotator cuff surgery on postoperative sporting activity. J Sports Med Phys Fitness. 2016. Systematic review reporting on return to sport for recreational and professional athletes.

59.

Lo IK, Burkhart SS. Transtendon arthroscopic repair of partial-thickness, articular surface tears of the rotator cuff. Arthroscopy. 2004;20(2):214–20. https://doi.org/10.1016/j.arthro.2003.11.042.CrossRefPubMed

Titel: Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes
verfasst von: Joseph N. Liu
Grant H. Garcia
Anirudh K. Gowd
Brandon C. Cabarcas
Michael D. Charles
Anthony A. Romeo
Nikhil N. Verma
Publikationsdatum: 13.01.2018
Verlag: Springer US
Erschienen in: Current Reviews in Musculoskeletal Medicine / Ausgabe 1/2018
Elektronische ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-018-9459-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Abstract

Purpose of Review

Recent Findings

Summary

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2018

The Role of Biologic Therapy in Rotator Cuff Tears and Repairs

Management of Rotator Cuff Injuries in the Elite Athlete

Hip and Groin Injuries in Baseball Players

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

Rotator cuff repair: post-operative rehabilitation concepts

Elbow Injuries in the Adolescent Thrower

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie