Exam 3: Rotator Cuff Tears Flashcards
A Rotator Cuff tear occurs where?
near the insertion on the greater tuberosity
What is the primary mechanism of RC tears?
acute trauma or chronic impingement
Impingement of the cuff against the _ in a sudden _ movement without proper _ of the humeral head
acromion; abduction; ER
What movements are weak with a RC tear?
abduction and ER
Patients with a RC tear will have difficulty _ movement
initiating
With a complete RC tear you will see loss of _
abduction (and/or ER)
Which type of diagnosis has the highest specificity?
MRI
What two types of surgeries an be done for partial thickness tears?
arthroscopic debridement and acomioplasty
Prognosis of a full thickness tear depends on _ and _ of the tear
history and size
Repair of a full thickness tear is warranted if _ and _ are prime objectives
strength and function
What factors play into decision making for a full thickness tear?
severity and duration of symptoms
functional limitations
patient demands and expectations
tear size and location
This type of RC repair is when they detach the deltoid off the acromion to repair the tear
Open repair
This type of RC repair is when they split along the lines of the fibers of the deltoid to repair the tear
mini-open or mini-cuff repair
This type of RC repair is when sutures are passed through the cuff before the deltoid is split to repair the tendon to bone
arthroscopic assisted
This type of RC repair is when the repair is performed totally arthroscopically
arthroscopic repair
Which type of arthroscopic has a steep learning curve but less morbidity with quicker recovery and cosmesis
Arthroscopic SAD
Minor tears may be treated as for _
tendinitis
Partial tears do not _ and may need _
heal, surgery
Full active _ shoulder _ and _ should not be initiated until 6-8 weeks after surgery
overhead shoulder flexion and abduction
What is seen with a degenerative RC disease?
painful arc reduced ROM (abd, ER, ext, hand behind back) reversed scapula-humeral rhythm pain and weakness with resistance tenderness on palpation
When should a total shoulder replacement be done?
with shoulder joint pain from destructive arthritis secondary to OA, RA, or traumatic arthritis
avascular necrosis
severe loss of UE strength
limitations of ADL
What position should the shoulder be held in post total shoulder?
adduction, IR and slight flexion
When can AAROM be progressed to AROM with a total shoulder?
mod protection (3-6 weeks)
ER can be done in moderate protection with _ of abduction and flexion
0
