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Z Orthop Unfall 2016; 154(01): 28-34
DOI: 10.1055/s-0035-1558056
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Aktuelle Behandlungskonzepte für Massenrupturen der Rotatorenmanschette

Current concepts for treatment of massive rotator cuff tears
S. A. Euler
1   Universitätsklinik für Unfallchirurgie, Medizinische Universität Innsbruck, Österreich
,
U. J. Spiegl
2   Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig
,
P. J. Millett
3   Orthopedics, The Steadman Clinic, Vail, Colorado, United States
,
M. Petri
4   Klinik für Unfallchirurgie, Medizinische Hochschule Hannover (MHH)
› Author Affiliations
Further Information

Publication History

Publication Date:
10 December 2015 (online)

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Zusammenfassung

Die Wahl der geeigneten Therapie einer Massenruptur der Rotatorenmanschette wird von Morphologie und Chronizität der Ruptur, Qualität der Muskeln und Sehnen, dem Ausmaß der vorliegenden Arthrose und patientenspezifischen Faktoren beeinflusst. Traditionell wurde fälschlicherweise „Massenruptur“ oft mit „irreparabler Ruptur“ gleichgesetzt. Zahlreiche Verbesserungen von Operationstechnik und -materialien ermöglichen jedoch inzwischen, dass bei Versagen der konservativen Therapie auch viele Massenrupturen erfolgreich arthroskopisch behandelt werden können. Diese Arbeit gibt eine Übersicht über die derzeit möglichen Verfahren zur Behandlung großer und massiver Rupturen sowie deren Erfolgsaussichten. Außerdem wird ein möglicher Behandlungsalgorithmus vorgeschlagen.

Abstract

The ideal treatment for massive rotator cuff tears is influenced by the morphology and chronicity of the tear, tissue quality, the degree of concomitant osteoarthritis, and patient-specific factors. Traditionally, massive rotator cuff tears have wrongly been equated with irreparable tears. A variety of improvements in surgical technique and materials now permit successful arthroscopic management of many massive rotator cuff tears when non-operative management has failed. This study provides an overview of the current treatment options for large and massive rotator cuff tears, including their expected outcomes. Finally, a possible treatment algorithm is suggested.

Schlüsselwörter

Rotatorenmanschette - Massenruptur - Rotatorenmanschettennaht - Behandlungsalgorithmus - Rekonstruktion

Key words

rotator cuff - massive rotator cuff tear - rotator cuff repair - treatment algorithm - reconstruction
 

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