Treatment of rotator cuff tear

Abstract

Shoulder impingement syndrome and rotator cuff tears are commonly encountered shoulder problems. Symptoms include pain, weakness and loss of motion. Subacromial impingement with subsequent tendinitis and bursitis is frequently found in young adult patients. Rotator cuff tears are a common cause of shoulder pain in patients over age 40. Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament，structural abnormalities of the acromion and weakness of the rotator cuff muscles. The majority of subacromial impingement and incomplete rotator cuff tears may be successfully managed with conservative treatment (rest，ice packs. nonsteroidal anti-inflammatory drugs and physical therapy). Conservative therapy has been recommended for the treatment of a chronic cuff lesion with relatively good results. However, recent reports about operative treatment of cuff lesions have yielded more favorable results. The indication for operative treatment was persistent, severe or moderate pain at rest and impairment of shoulder function after initial conservative treatment. This article discusses etiology and treatment of rotator cuff disorders in the primary care setting. We recommend operative treatment of the rotator cuff for all cases in which the tear is full thickness. regardless of tear size，if patients have any symptoms. especially pain. When surgery is associated with a careful rehabilitation programme it may frequently allow patients to return to their baseline function.