Point-Counterpoint: Rotator Cuff Tears-Point-Counterpoint: Rotator Cuff Tears

Video Transcription

Video Summary

Dr. Robbie Bowers and Dr. Matthew Best discuss the management of rotator cuff tears in this video transcript. They present a case of a 45-year-old male with a partial tear who wants to go on a golf trip. Non-surgical options such as physical therapy and injections are suggested to achieve the patient's goal. The importance of evaluating the MRI to assess the tear's depth and width is emphasized. Suprascapular nerve blocks and injections like corticosteroids or Catorlac are discussed for pain relief. Hyaluronic acid injections are mentioned as a potential option, depending on insurance coverage. The importance of individualized treatment plans based on patient goals is highlighted.<br /><br />In the first case, an MRI is recommended for a traumatic injury in patients with significant weakness or those over 40. The decision is made sooner for young athletes and professionals. Delaying consultation for too long is a concern.<br /><br />The second case involves a 65-year-old female tennis player with a tear of the infraspinatus and supraspinatus tendons. Conservative treatment with physical therapy is initially recommended, followed by cortisone injections if progress is not achieved. Surgery may be considered, with an inferior trapezius tendon transfer being preferred over a superior capsular reconstruction. The rehabilitation protocol includes passive and active motion, as well as strengthening exercises. The choice of orthobiologic treatment, such as platelet-rich plasma (PRP), depends on the tear's size and type.<br /><br />Credits to Dr. Robbie Bowers and Dr. Matthew Best for their insights and recommendations in the video.

Keywords

rotator cuff tears

management

non-surgical options

MRI evaluation

injections

physical therapy

suprascapular nerve blocks

corticosteroids

hyaluronic acid injections

individualized treatment plans

orthobiologic treatment