The rotator cuff is the most common source of shoulder pain and disability. The majority
of rotator cuff injuries are caused by overuse, with the supraspinatus, a small tendon
with a poor blood supply, most commonly affected. The major function of the rotator
cuff is to stabilize the glenohumeral joint during active arm elevation by opposing
the superior vector of the deltoid’s force. As long as the ability to actively elevate
the arm is maintained, all rotator cuff injuries, including full-thickness tears,
are candidates for nonsurgical management, the basis of which is strengthening of
the rotator cuff and scapulothoracic stabilizers. Surgery should be considered for
those patients who fail to improve after at least 3 months of nonsurgical management.
Arthroscopic rotator cuff debridement without acromioplasty has short-term and long-term
results equal to, if not superior to, subacromial decompression. Avoidance of iatrogenic
injury to the coracoacromial arch, which is a secondary static stabilizer of the humeral
head against anterosuperior migration, contributes to a low complication rate.
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© 2005 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
