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Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann J Bone Joint Surg Am Volume 88(10):2294-2302 October 1, 2006 ©2006 by The Journal of Bone and Joint Surgery, Inc.

Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

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Page 1: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma

by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

J Bone Joint Surg AmVolume 88(10):2294-2302

October 1, 2006

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Positive hornblower's sign.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Fig. 2 T1-weighted magnetic resonance imaging scan demonstrating severe fatty deposition (arrow) and muscle atrophy in an irreparable rotator cuff tear.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Fig. 3 Latissimus dorsi tendon transfer technique.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Fig. 4 Subcoracoid pectoralis major transfer technique.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

A shoulder hemiarthroplasty with an extended-coverage head used to treat an irreparable rotator cuff tear and glenohumeral arthritis in a patient with a competent coracoacromial arch.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Irreparable Rotator Cuff Tears: What to Do and When to Do It; the Surgeon's Dilemma by David M. Dines, Daniel P. Moynihan, Joshua S. Dines, and Peter McCann

Treatment algorithm for patients with an irreparable rotator cuff tear.

David M. Dines et al. J Bone Joint Surg Am 2006;88:2294-2302

©2006 by The Journal of Bone and Joint Surgery, Inc.