Management of disorders of the rotator cuff: proceedings of the ISAKOS upper extremity committee consensus meeting
In the shoulder complex, a closed chain is present between the thorax, scapula and clavicle, which ensures optimal positioning of the humeral head. Disruptions in only one element of this system, such as the scapula, will alter the movement behavior of other elements and may limit the rotator cuff in providing stability to the glenohumeral joint.
Recently, the insertional anatomy of the supraspinatus and infraspinatus muscles has been updated: the infraspinatus inserts as two seperate, transverse and oblique tendons onto a large portion of the greater tuberosity, whereas the supraspinatus inserts on a smaller upper aspect of the greater tuberosity.
The overall methodological quality of a full clinical examination procedure to rule out full thickness rotator cuff tears is about 90% - making in it equally accurate as the current imaging technology. Nevertheless, no single test in the clinical examination is highly accurate.
Arthroscopic rotator cuff repair seems superior to open repair: it lowers postoperative infection rates and keeps the deltoid muscle largely intact. This decreases postoperative loss of motion and pain levels and accelerates postoperative rehabilitation. > From: Arce et al., Arthroscopy 29 (2013) 1840-1850. All rights reserved to Elsevier Inc.
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