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Open rotator cuff repair
remains the gold standard for addressing large, retracted rotator cuff tears. Despite advances in arthroscopic techniques, to date there is a lack of consistent evidence that one technique is superior. We review anatomical considerations in rotator cuff tear development as well as clinical examination and useful investigations. Open approach to rotator cuff repair is utilized in combination with arthroscopic assessment and preparation. Indications for an open approach relate to size, mobility and configuration of the tear. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 9, 2014 Category: Orthopaedics Authors: Jennifer N Flynn, Malin Wijeratna, Eugene T.H. Ek, Gregory A. Hoy Source Type: research

Arthroscopic Subscapularis Repair
For years subscapularis tendon tears have been considered a relatively rare diagnosis with an incidence of 3.5% to 8% among all rotator cuff tears. In recent years, however, the incidence of subscapularis tears has increased to 37%. This significant change has been mostly associated with a better understanding of anatomy and physical examination, improved radiographic imaging, and more prevalent use of arthroscopic technology.The purpose of this chapter is to provide a step-by-step outline of the latest evidence based practice for arthroscopic subscapularis repair. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 9, 2014 Category: Orthopaedics Authors: Hristo I. Piponov, Aneet S. Toor, Lewis L. Shi Source Type: research

Natural History of Rotator Cuff Disease and Implications on Management
Degenerative rotator cuff disease is commonly associated with ageing and is often asymptomatic. The factors related to tear progression and pain development are just now being defined through longitudinal natural history studies. The majority of studies that follow conservatively treated painful cuff tears or asymptomatic tears that are monitored at regular intervals show slow progression of tear enlargement and muscle degeneration over time. These studies have highlighted greater risks for disease progression for certain variables, such as the presence of a full-thickness tear and involvement of the anterior aspect supras...
Source: Operative Techniques in Orthopaedics - December 9, 2014 Category: Orthopaedics Authors: Jason Hsu, Jay D Keener Source Type: research

Operative Technique on Arthroscopic Partial-Thickness Articular Rotator Cuff Repairs
Since its first description in 1931, there has been an evolution in the understanding of partial articular tears of the supraspinatus. Partial articular supraspinatus tendon avulsion represents a Southern California Orthopaedic Institute type 3 or 4 tear classification with a traumatic etiology. Partial-thickness tears have little active healing response and may progress to a full-thickness tear. These tears are painful for patients and are particularly debilitating for overhead activities. A tear that involves more than 50% of the tendon may require surgical intervention after extensive conservative management. (Source: O...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Jeremie M. Axe, Nathan J. Sinz, Laurence D. Higgins Source Type: research

Introduction
Tears of the rotator cuff were initially described in the early 1800s, with Dr Codman credited for performing the first successful repair in 1909. Since then, the assessment and management of rotator cuff tears has evolved significantly. Currently, rotator cuff tears are one of the most commonly diagnosed orthopaedic conditions with repair among the top 10 orthopaedic procedures performed worldwide. Surgical repair techniques in turn have evolved from traditional open and miniopen approaches with transosseous fixation to arthroscopic single- and double-row “transosseous-equivalent” suture anchor fixation to yet newer t...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Albert Lin Source Type: research

Shoulder and Rotator Cuff Repair: Single vs Double Row
Rotator cuff tears are a common cause of upper extremity pain and dysfunction. The purpose of this article is to briefly review the preoperative assessment of patients with rotator cuff tears, including history, physical examination, and imaging of the shoulder. Its emphasis is to outline both the single-row and double-row arthroscopic rotator cuff repair techniques. Although there is no universally accepted best technique for arthroscopic rotator cuff repair, a surgeon’s experience, patient’ expectation, and technical considerations—including available equipment, tissue quality, and the size of the tear—are key to...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Michael T. Freehill, Jason P. Rogers, Sandeep Mannava Source Type: research

Introduction to Operative Techniques in Orthopaedics: Shoulder and Rotator Cuff Repair
Tears of the rotator cuff were initially described in the early 1800s, with Dr. Codman credited for performing the first successful repair in 1909. since then, the assessment and management of rotator cuff Tears has evolved significantly. currently, rotator cuff Tears are one of the most commonly diagnosed orthopedic conditions with repair among the top ten orthopedic procedures performed worldwide. surgical repair techniques in turn have evolved from traditional open and mini-open approaches with transosseous fixation to arthroscopic single- and double-row “transosseous equivalent” suture anchor fixation to yet newer ...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Albert Lin Source Type: research

Operative Technique on Arthroscopic Partial-Thickness Articular- Rotator Cuff Repairs
Since its first description in 1931, there has been an evolution in the understanding of partial articular tears of the supraspinatus. Partial articular supraspinatus tendon avulsion (PASTA) represents a SCOI type 3 or 4 tear classification with a traumatic etiology. Partial-thickness tears have little active healing response and may progress to a full-thickness tear. These tears are painful for patients and are particularly debilitating for overhead activities. A tear that involves over 50% of the tendon may require surgical intervention after extensive conservative management. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Jeremie M. Axe, Nathan J. Sinz, Laurence D. Higgins Source Type: research

Arthroscopic double-row rotator cuff repair using a knotless, interconnected technique
The surgical techniques used for rotator cuff repair have evolved over the past three decades. Technical innovations have contributed to improved clinical outcomes following repair. Recently, double-row repairs have demonstrated substantial biomechanical advantages when compared to single-row repairs, including decreased gap formation, increased ultimate load-to-failure, and improved footprint coverage. Knotless transosseous equivalent rotator cuff repair has emerged as an alternative to knotted constructs. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Ryan J. Warth, Joshua A. Greenspoon, Sanjeev Bhatia, Peter J. Millett Source Type: research

Postoperative rotator cuff repair rehabilitation and complication management
Selection and management of a post-operative rotator cuff repair rehabilitation protocol is a vital component in achieving the patient’s pain control, a reliable return to activities and pre-injury level, re-tear risk management, and overall surgical outcome. Optimal treatment approaches require a team effort; open communication between the surgeon, the therapist, and the patient; with continual reassessment and a step-wise staged protocol progression. Much work has been done to identify high-level evidence-based rotator cuff rehab protocols and identify risk factors for complications and tendon failure. (Source: Operati...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Frank McCormick, Reginald B. Wilcox, Arnold Alqueza Source Type: research

Shoulder and Rotator Cuff Repair: single versus double row
Rotator cuff tears are a common cause of upper extremity pain and dysfunction. The purpose of this chapter is to briefly review the preoperative assessment of patient’s with rotator cuff tears including history, physical examination, and imaging of the shoulder. The emphasis of this chapter is to outline both the single row and double row arthroscopic rotator cuff repair technique. Although there is no universally accepted best technique for arthroscopic rotator cuff repair, a surgeon’s experience, patient expectation, and technical considerations—including available equipment, tissue quality, and the size of the tea...
Source: Operative Techniques in Orthopaedics - December 8, 2014 Category: Orthopaedics Authors: Michael T. Freehill, Jason P. Rogers, Sandeep Mannava Source Type: research

Editorial Board
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 1, 2014 Category: Orthopaedics Source Type: research

Table of Contents
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 1, 2014 Category: Orthopaedics Source Type: research

Contributors
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - December 1, 2014 Category: Orthopaedics Source Type: research

Editorial Board
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 1, 2014 Category: Orthopaedics Source Type: research