Rotator cuff deficiency of the shoulder

201 Pages·2008·11.737 MB·English

by  Mark A. Frankle

Rotator Cuff Defi ciency of the Shoulder

Rotator Cuff Defi ciency
of the Shoulder
Mark A. Frankle, MD
Chief
Shoulder and Elbow Sugery
Florida Orthopaedic Institute Research Foundation
Temple Terrace, Florida
Thieme
New York • Stuttgart
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Library of Congress Cataloging-in-Publication Data
Rotator cuff defi ciency of the shoulder / [edited by] Mark A. Frankle.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–1–58890–506–2 (tpn : alk. paper)
1. Shoulder joint—Rotator cuff—Diseases. I. Frankle, Mark A.
[DNLM: 1. Rotator Cuff—surgery. 2. Arthroscopy. 3. Joint Prosthesis. 4. Rotator Cuff—injuries. WE 810 R8417 2008]
RD557.5.R669 2008
617.4’720597—dc22
2007044534
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ISBN 978-1-58890-506-2
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
1 Biomechanics of Pathophysiology and Repair of Rotator Cuff Tears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Kai-Nan An
2 Massive Irreparable Rotator Cuff Tears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Mark Mighell
3 Classifi cation of Rotator Cuff–Tear Arthropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Ludwig Seebauer
4 Arthroscopic Management of Massive Rotator Cuff Tears. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
James C. Esch and Yuri M. Lewicky
5 Muscle Transfers for the Treatment of the Irreparable Rotator Cuff Tear . . . . . . . . . . . . . . . . . . . . . . . . . 37
Robert C. Decker and Spero G. Karas
6 The Spectrum of Disease in the Rotator Cuff–Defi cient Shoulder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Jonathan Levy
7 Hemiarthroplasty for Rotator Cuff–Tear Arthropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Kamal I. Bohsali, Jeffrey L. Visotsky, Carl J. Basamania, Michael A. Wirth, and Charles A. Rockwood Jr.
8 Rationale and Biomechanics of the Reversed Shoulder Prosthesis: The American Experience. . . . . . . 76
Mark A. Frankle, Nazeem Virani, Derek Pupello, and Sergio Gutierrez
9 Rationale and Biomechanics of the Reversed Shoulder Prosthesis: The French Experience . . . . . . . .105
Pascal Boileau and Christopher Chuinard
10 Treating the Rotator Cuff–Defi cient Shoulder: The Lyon, France, Experience . . . . . . . . . . . . . . . . . . . .120
Gilles Walch and Bryan Wall
11 Treating the Rotator Cuff–Defi cient Shoulder: The Mayo Clinic Experience . . . . . . . . . . . . . . . . . . . . .135
John W. Sperling and Robert H. Cofi eld
vi Contents
12 Treating the Rotator Cuff–Defi cient Shoulder: The Columbia University Experience. . . . . . . . . . . . . .138
John-Erik Bell, Sara L. Edwards, and Louis U. Bigliani
13 Treating the Rotator Cuff–Defi cient Shoulder: The Florida Orthopaedic Institute Experience . . . . . .147
Mark A. Frankle, Derek Pupello, and Derek Cuff
14 Tissue Engineering for the Rotator Cuff–Defi cient Shoulder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
Joshua S. Dines, Daniel P. Grande, and David M. Dines
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Foreword
Rotator cuff problems are the most common source of ics of the upper extremity, and he codifi es his understanding
shoulder pain, and as such are thoughtfully included in the of these concepts in the introductory chapter. Other schol-
diagnostic evaluation of patients presenting with shoulder arly authors bring to the book focused information on epide-
pain. A tremendous spectrum of injury and disease affects miology and natural history, conservative treatment, arthro-
the rotator cuff. The list of issues is almost too long to enu- scopic initiatives, muscle replacement, tendon replacement,
merate, including strain, infl ammation, abrasion, partial and the thoughtful reminder of the full spectrum of disease
tearing with tear sizes extending from small to extra-large, that can occur within this area. The main subject, cuff tear
and acute or chronic full-thickness tearing. Related issues arthropathy, is introduced with a thorough discussion of
involving the long-headed biceps, degenerative changes on classifi cation systems defi ning the various components of
the acromion process or hypertrophic enlargement of the this problem. In considering prosthetic replacement, the
acromioclavicular joint, stiffness or instability, and varying tried-and-true role of hemiarthroplasty is presented with its
degrees of associated arthritic involvement of the gleno- great benefi ts and its striking limitations as well. The coup
humeral joint also affect the rotator cuff. One can spend de grâce, though, is the magnifi cently expansive discussion
an entire professional career studying these various areas of the rational and mechanics for the reverse shoulder pros-
and trying to reach conclusions about the best treatment thesis. This is coupled with exposition of the clinical experi-
utilizing current knowledge. ence from four centers. These unaltered opinions side by
Over the last several decades, a revolution has occurred. side allow the reader to compare and contrast viewpoints—
The introduction of arthroscopy and the development of something that just cannot be done in scientifi c journals,
arthroscopic surgical tools have created an entirely new but only in a textbook setting.
approach to dealing with rotator cuff problems. Magnetic We are all well schooled in the concepts of evolution
resonance imaging has allowed visualization of details of and the supposition that things slowly change over time.
the rotator cuff and its musculature that was heretofore In fact, the changes are uneven in magnitude and have no
not possible. A new type of shoulder prosthesis has been set schedule. The quite dramatic, rapid changes that have
introduced to replace not only arthritic joint surfaces but occurred in this area may have been completed in our pro-
also a defi cient rotator cuff. Earlier attempts at this had fessional lifetimes. As we are unable to predict the future
been inconsistent with limited effectiveness. However, with any degree of accuracy, I think we all must believe
now there is promise that a new implant, the reverse type that the material included in this text may endure for quite
of shoulder prosthesis, will have the necessary consistency some time. Congratulations to Dr. Frankle for developing
and effectiveness to become a fi rst-line treatment choice the concept for this book so wonderfully and to all the au-
for patients with concordant rotator cuff defi ciency, sub- thors for helping us to better understand rotator cuff de-
stantial arthritis, and usually a lack of active motion away fi ciencies and their myriad manifestations of presentation
from the side. and nuances for treatment.
Dr. Mark A. Frankle, the editor of this book, is an ex-
tremely energetic champion to further the understanding Robert H. Cofi eld, MD
of the rotator cuff defi cient shoulder and its treatment. He Caywood Professor of Orthopaedics
has brought together a magnifi cent set of chapters by au- Mayo Clinic College of Medicine
thors with unparalleled scientifi c background and practical Consultant in Orthopaedic Surgery
experience. For example, Professor Kai-Nan An has authored Mayo Clinic
hundreds of peer-reviewed manuscripts on the biomechan- Rochester, Minnesota

Preface
In the early 21st century, the diseases faced by developed of the problem, which suggests a course of benign neglect.
nations have begun to shift. The number of people who are To stop this problem, we must identify nonoperative treat-
over 50 years of age will soon outnumber those under 50. ments that compensate for the rotator cuff defect and
This demographic change will correspondingly increase consider operative treatments such as reconstructive sur-
the disease burden in this segment of the aging popula- gery. To this end, I have recruited physicians from around
tion. It is estimated that once a person reaches the age of the world who have demonstrated their authority on the
65, he or she has a 50% chance of developing a torn rotator successful treatment of patients with a rotator cuff–de-
cuff. The millions of people already affected by rotator cuff fi cient shoulder. The historical perspective, classifi cation,
disease has accounted for billions of dollars in health-care and nonoperative and operative management of rotator
costs to diagnose and treat this problem. Additionally, the cuff disease of various well-known institutions is shared
economic impact of disabled workers due to rotator cuff within several unique chapters. It is my hope that this book
injuries cannot be overstated. Although the majority of will be helpful to orthopedic surgeons who focus on treat-
these patients are able to be treated conventionally for re- ing patients with shoulder problems by providing an array
pairable rotator cuff tears, there exists an ever-increasing of successful treatment methodologies.
number of patients faced with an irreparable tear. Many
of these people are often given confusing information re-
garding their options and are offered treatments unlikely
to help. As a result, they may increase their pain and di-
Acknowledgment
minish their shoulder function.
This situation has evolved from a combination of factors For their efforts, I would like to acknowledge all the con-
including our inability as physicians to recognize when tributing authors and the research group at the Florida
these tears are beyond repair with conventional methods Orthopaedic Institute Research Foundation led by Derek
and our reluctance to recognize the increasing magnitude Pupello, whose help has been immeasurable.