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OCS > Rotator Cuff > Flashcards

Rotator Cuff Flashcards

1
Q

What is a full thickness tear of the rotator cuff?

A

Tears that comprise the entire thickness (from top to bottom) of the rotator cuff tendon or tendons.

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2
Q

What is often associated with a tear of the subscapularis tendon?(2)

A
  1. Subluxation of the bicep long tendon from the intertubercular groove.
  2. Partial or complete tears of biceps tendon
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3
Q

What are partial thickness rotator cuff tears?

A

Partial thickness tears can occur on the superior surface (bursal side) or the undersurface (articulate side) of the rotator cuff.

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4
Q

What are partial thickness tears on the undersurface(articular side) of the rotator cuff generally associated with?

A
  1. Tensile loads
  2. Glenohumeral joint instabilities
  3. Commonly found in overhead throwing athletes
  4. Athletes usually have
    - anterior instability
    - capsular and labral insufficiency
    - dynamic muscular imbalance
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5
Q

What are sizes of thickness rotator cuff tears? (4)

A
  1. Small tear 1 cm across
  2. medium tears between 1 -3cm
  3. large tears between 3 -5 cm
  4. massive tears larger than 5cm
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6
Q

Post operative treatment of complete rotator cuff tear are based on what principles?(3)

A
  1. Tear pattern recognition
  2. Secure fixation
  3. Restoration of the footprint
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7
Q

What are the two types of tear patterns?

A
  1. Crescent shape
    - do not usually retract from greater tuberosity
    - usually repaired back to greater tuberosity
  2. U pattern-
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8
Q

What are the type of suture placement?(3)

A
  1. Simple
  2. Mattress
  3. combination(modified Mason-Allen)
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9
Q

What is important with suture placement?(2)

A
  1. How secure the sutures are tied

2. How much load is carry across each suture

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10
Q

What is a better suture double or single row?

A
  1. Clinical reports demonstrate good results with either a single or double row technique.
  2. Double row results in closer re-approximation of rotator cuff footprint
  3. Double roll repairs have theoretical ability to increase healing potential and ultimately tensile strength
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11
Q

Supraspinatus origin, insertion and nerve?

A
  1. Origin-supraspinatus Fosse the scapula
  2. Insertion-Greater tubercle of humerus
  3. Subscapular nerve C4-C6
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12
Q

Infraspinatus origin, insertion and nerve?

A
  1. Origin-Infraspinous Fosse the scapula
  2. Insertion-Greater tubercle of humerus
  3. Subscapular nerve C5-C6
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13
Q

Teres Minor origin, insertion and nerve?

A
  1. Origin-Lateral border of scapula
  2. Insertion-Greater tubercle of humerus
  3. Axillary nerve C5-C6
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14
Q

Subscapularis origin, insertion and nerve?

A
  1. Origin-Subscapular foss
  2. Insertion-Lesser tubercle of humerus
  3. Upper and lower subscapular nerve C5-C6
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15
Q

Transosseous equivalent or suture bridge technique has shown to do what? (2.)

A
  1. Increase fixational strength

2. Greater tendon bone content forces surface area compared to both single row and double row strategy.

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16
Q

What do initial post surgical rehabilitation focus on?

A
  1. ROM to prevent capsular adhesions

2. Protecting surgical repaired tissue

17
Q

What does the Biceps do in the setting of rotator cuff tears?

A

Active contraction of biceps prevents superior migration, normalizing kinematic of GHJ.

18
Q

What is a Bursal-sided rotator cuff tear?(3)

A
  1. Partial-thickness RTC tears extending from the bursal side into the RTC
  2. Less common than articular-sided rotator cuff tears
  3. Associated with subacromial impingement and spurs on the acromion undersurface
19
Q

What is a Articular-sided rotator cuff tear?(4)

A
  1. Articular-sided RTC are referred to as partial-thickness RTC tears extending from the articular side into the rotator cuff.
  2. Commonly occur in athletes with overhead activity
  3. less common than intra-substance tears in the general population but more common than bursal-sided tears
  4. Extrinsic factor is glenohumeral instability
20
Q

What is a Intrasubstance rotator cuff tears?(3)

A
  1. Concealed partial-thickness rotator cuff tear neither extending to the articular nor the bursal side of the rotator cuff.
  2. Most common form of partial-thickness RTC tear.
  3. Most commonly found in the posterior supraspinatus tendon
21
Q

What is the clinical presentation for subacromial Impingement?(6)

A
  1. Painful arc
  2. increased pain with OH activity
  3. reaching across the body
  4. reaching behind back
  5. sleeping
  6. pain likely localized to anterior lateral shoulder

OCS (18 decks)

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