Evaluation and Management of Rotator Cuff Tears Following Shoulder Dislocation.

IF 3.9 2区 医学 Q1 ORTHOPEDICS
Natalie K Kucirek, Jamie E Confino, Brian Feeley, Michael R Davies
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Abstract

Purpose of review: This review aims to summarize the epidemiology, associated pathology, and treatment options for rotator cuff tears following shoulder dislocations and to provide a treatment algorithm for these complex injuries.

Recent findings: Rotator cuff tears after shoulder dislocations most often occur in patients older than 40 and may be more prevalent in women. Up to 50% of these patients may have concomitant Bankart lesions. Patients treated nonoperatively generally have worse functional outcomes and higher pain scores than those who undergo rotator cuff repair. However, further studies are needed to elucidate when the rotator cuff can be repaired in isolation versus in combination with capsulolabral stabilization. Reverse total shoulder arthroplasty is a viable treatment option for elderly patients with irreparable cuff tears after dislocation or post-instability arthropathy. Patients who sustain a shoulder dislocation should be evaluated for a rotator cuff tear, particularly if older than 40. Those with post-instability full-thickness rotator cuff tears benefit from surgical treatment. Further research is needed to clarify when additional stabilization procedures should be performed alongside rotator cuff repair.

Abstract Image

肩脱位后肩袖撕裂的评估与处理。
综述目的:本综述旨在总结肩脱位后肩袖撕裂的流行病学、相关病理学和治疗方案,并为这些复杂损伤提供一种治疗方法。最近的研究发现:肩脱位后的肩袖撕裂最常发生在40岁以上的患者中,可能在女性中更为普遍。高达50%的患者可能伴有Bankart病变。非手术治疗的患者通常比接受肩袖修复的患者有更差的功能结果和更高的疼痛评分。然而,需要进一步的研究来阐明什么时候可以单独修复肩袖,什么时候可以联合肩关节囊稳定。逆行全肩关节置换术是一种可行的治疗方案,用于老年患者脱位或不稳定后的关节病变后不可修复的袖带撕裂。肩关节脱位的患者应接受肩袖撕裂检查,尤其是年龄超过40岁的患者。不稳定后全层肩袖撕裂者可从手术治疗中获益。需要进一步的研究来阐明在肩袖修复的同时,什么时候应该进行额外的稳定手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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