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Management of Massive Irreparable Rotator Cuff Tears

Management of Massive Irreparable Rotator Cuff Tears
Eoin Ó Conaire reviews the evidence on massive irreparable rotator cuff tears, including his own Delphi study, and sets out the key parts of physiotherapy assessment and treatment. Read more ↓
4 Episodes 55m
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Episodes
01
Defining Massive Irreparable Cuff Tears, Imaging and Presentation

How massive irreparable rotator cuff tears are defined, which X-ray and MRI signs predict that a tear cannot be repaired, how these patients present in clinic, and why they struggle to lift the arm above shoulder height.

11:52
02
Reverse Shoulder Arthroplasty Versus Physiotherapy Programs

The treatment options for massive irreparable rotator cuff tears, the benefits, complications and costs of reverse shoulder arthroplasty, and what the studies on anterior deltoid and other physiotherapy programs show.

11:05
03
Predicting Physiotherapy Outcome and the International e-Delphi Study

Which factors predict whether a patient with a massive irreparable rotator cuff tear will do well with physiotherapy, from tear pattern and range of motion to expectation and self-efficacy, and the results of an international e-Delphi study.

13:33
04
Targeted Assessment, Explanation and Goal Setting for Cuff Tears

How to turn the prognostic factors for massive irreparable rotator cuff tears into a targeted assessment and treatment, with attention to expectations, explanation, collaborative goal setting and knowing when to refer on.

18:59

In this lecture, I talk about the management of massive irreparable rotator cuff tears and summarise the literature in the area including my own research to help provide insight into what we should do clinically. I then provide guidance on the key components of the physiotherapy assessment and targeted treatment with these patients.

Key learning points

  • What are massive irreparable rotator cuff tears?
    • Radiological features, patient characteristics, biomechanics
  • What are the treatment options?
    • Surgical & non-surgical
  • The challenges of clinical decision-making
  • Overview of physiotherapy programmes for massive irreparable rotator cuff tears
    • Content, evidence, efficacy
  • What are the prognostic factors for success with physiotherapy?
  • Results of our international Delphi study
  • What are the key components of the physiotherapy assessment?
  • What are the key elements of targeted physiotherapy intervention?
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