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History of rotator cuff surgery

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Rotator cuff surgery is a rapidly evolving branch in orthopaedics, which has raised from a minor niche to a fully recognized subspecialty. This article summarizes its history, examining the development of its key principles and the technical advancements.

Methods

Literature was thoroughly searched, and few senior surgeons were interviewed in order to identify the significant steps in the evolution of rotator cuff surgery.

Results

A wide variety of surgical options is available to reduce pain and restore function after rotator cuff tears. Rotator cuff repair surgical techniques evolved from open to arthroscopic and are still in development, with new fixation techniques and biological solutions to enhance tendon healing being proposed, tested in laboratory and in clinical trials. Although good or excellent results are often obtained, there is little evidence that the results of rotator cuff repair are improving with the decades. An overall high re-tear rate remains, but patients with failed rotator cuff repairs can experience outcomes comparable with those after successful repairs.

Conclusions

Rotator cuff repair techniques evolve at a fast pace, with new solutions often being used without solid clinical evidence of superiority. It is necessary to conduct high-level clinical studies, in which data relating to anatomical integrity, patient self-assessed comfort and function, together with precise description of patient’s condition and surgical technique, are collected.

Level of evidence

IV.

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Authors and Affiliations

  1. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy

    Pietro Randelli, Davide Cucchi, Vincenza Ragone & Paolo Cabitza

  2. IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy

    Pietro Randelli, Davide Cucchi, Vincenza Ragone & Paolo Cabitza

  3. Laboratorio di Biotecnologie applicate all’Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi, 4, 20161, Milan, Italy

    Laura de Girolamo

  4. IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Mario Randelli

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  1. Pietro Randelli
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Randelli, P., Cucchi, D., Ragone, V. et al. History of rotator cuff surgery. Knee Surg Sports Traumatol Arthrosc 23, 344–362 (2015). https://doi.org/10.1007/s00167-014-3445-z

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