회전근개 파열의 수술적 치료: 그리고 앞으로 나아갈 길

Abstract

Background: Among many diseases associated with shoulder pain, rotator cuff tear with and without arthritis accounts for most of the surgical cases. We aimed to briefly review the arthroscopic surgical treatment and prognosis for rotator cuff tears. Current Concepts: Traditionally, rotator cuff tears have been treated using open surgery; however, with the development of arthroscopic surgery, the arthroscopic suture method has been preferred. Nevertheless, in cases of partial rotator cuff tears exceeding more than 50% of the total thickness and not responding to conservative treatment for longer than 6 months, surgical treatment is considered. In cases of complete rotator cuff tears, in addition to the preoperative factors, the amount of tension applied to the suture site at the time of surgery and force coupling recovery of the rotator cuff are important factors for successful arthroscopic suturing. Furthermore, various methods such as patch augmentation using human dermis or bone marrow stimulation have been utilized to increase the success rate of sutures in extensive rotator cuff tears. Even after cuff repair, appropriate rehabilitation and pain control are important for optimal outcomes. Superior capsule reconstruction has gained substantial attention since it was first reported; however, further studies on its feasibility, indications, and outcomes are warranted. Discussion and Conclusion: We reviewed the arthroscopic surgical treatment and prognosis for rotator cuff tears. The study reveals that the prognosis can be improved if the treatment is tailored to the individual patient's environment or situation.