Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2015; 6(10): 770-775
Published online Nov 18, 2015. doi: 10.5312/wjo.v6.i10.770
Treatment options for irreparable postero-superior cuff tears in young patients
Olimpio Galasso, Filippo Familiari, Giorgio Gasparini
Olimpio Galasso, Filippo Familiari, Giorgio Gasparini, Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
Author contributions: Galasso O, Familiari F and Gasparini G contributed evenly to this paper.
Conflict-of-interest statement: The authors did not receive any funding or grants in support of their research for or preparation of this work. The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Filippo Familiari, MD, Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University of Catanzaro, Campus “S.Venuta”, V.le Europa (Loc. Germaneto), 88100 Catanzaro, Italy. filippofamiliari@gmail.com
Telephone: +39-0961-3647001 Fax: +39-0961-3647104
Received: February 21, 2015
Peer-review started: February 22, 2015
First decision: July 10, 2015
Revised: September 7, 2015
Accepted: September 25, 2015
Article in press: September 28, 2015
Published online: November 18, 2015
Processing time: 264 Days and 7.6 Hours
Abstract

Rotator cuff tears (RCTs) occur more commonly with advanced age, with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs. Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population, and the incidence of irreparable RCTs in young patients is still unknown. Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse shoulder arthroplasty. After being thoroughly investigated in open surgery, arthroscopic techniques for latissimus dorsi tendon transfer have been recently described. They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.

Keywords: Postero-superior rotator cuff tears; Young patients; Irreparable; Latissimus dorsi; Tendon transfer

Core tip: Irreparable postero-superior cuff tears have been reported as frequent as 7% to 10% in the general population, and they are challenging, especially in young and active patients. In this patient population, the number of therapeutic options dramatically decreases. Several surgical procedures have been proposed for young patients with irreparable postero-superior rotator cuff tears, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse total shoulder arthroplasty. Latissimus dorsi tendon transfer seems to be a viable option to restore function and decrease pain in young and active patients.