Nerve problems related to the shoulder
The orthopedic surgeon is often the first to correctly identify a nerve problem related to the shoulder. Patients may have a chief complaint of shoulder pain that in fact is…
Approach to the irreparable cuff tear and failed cuff repair
Introduction The goal of rotator cuff repair is to anatomically repair the rotator cuff with a biomechanically sound construct while respecting the biology of the tissues. Long-term follow-up demonstrates that…
Nonoperative management of rotator cuff disease
Introduction While descriptions of rotator cuff tears have been noted at least as early as 1788, the first surgical repair of a rotator cuff tear is credited to Muller in…
Rehabilitation after rotator cuff repair
Multiple factors interplay to determine whether a repaired rotator cuff will heal. These include patient age, size of the tear, chronicity of the tear, the biologic milieu, tissue quality, the…
Opinion editorial—shoulder reconstruction in adult patients with brachial plexus injury
ABOUT THE EXPERT Bassem T. Elhassan, MD, is a professor of orthopedic surgery and shoulder, elbow, and hand surgery at the Mayo Clinic. His upper extremity training started with a…
Opinion editorial—lessons learned treating patients with previous rotator cuff repairs
ABOUT THE EXPERT April Armstrong, BSc(PT), MD, MSc, FRCSC, is a professor of orthopedics, acting chair, and chief of the shoulder service at Penn State Health in Hershey, Pennsylvania. She…
Epidemiology and natural history of rotator cuff disease
Introduction The management of degenerative rotator cuff disease is controversial, and surgical indications vary widely. With increasing utilization of surgical management for rotator cuff disease, ensuring a complete understanding of…
The 13-point shoulder ultrasound examination
The first documented protocol for using musculoskeletal (MSK) ultrasound to evaluate the shoulder was published in 1984 by Middleton et al. Since 1984, there have been ongoing advances in ultrasound…
Anterior instability: Epidemiology, history, physical examination, imaging, and nonoperative treatment
Epidemiology Anterior shoulder instability can arise from primarily three different etiologies: trauma, congenital laxity, and acquired laxity. Determining the difference between instability and laxity is essential. Matsen proposed most patients…
Structure and function of the rotator cuff
Rotator cuff structure Anatomic overview The rotator cuff consists of four muscle-tendon units: the subscapularis, infraspinatus, supraspinatus, and teres minor ( Fig. 50.1 ). These four muscles have their origins…
