TỔNG QUAN VỀ RÁCH RỘNG GÂN CHÓP XOAY

Abstract

Objective: The article summarizes the definition, pathogenesis, and treatment methods for massive rotator cuff tears (MRCT). Methods: A literature review on MRCT, focusing on definition, biomechanics, diagnosis, and treatment. Results: MRCT is defined as a tear involving 2 or more tendons or a tear larger than 5 cm, associated with force imbalance and shoulder joint kinematics disorder. Diagnosis is based on clinical assessment and MRI. Treatment choice depends on age, tissue degeneration, tendon retraction, and functional demands. Treatment methods include: 1) Conservative treatment: physical therapy and pain medication, recommended for elderly patients or those with underlying conditions. 2) Debridement and subacromial decompression: suitable for elderly patients without pseudoparalysis. 3) Tendon repair: Two-row repair is preferred if feasible. 4) Partial tendon repair: considered when complete repair is not possible. 5) Augmentation with grafts: remains controversial. 6) Superior capsule reconstruction: a new method, requiring further research. 7) Tendon transfer: suitable for younger, active patients. 8) Subacromial spacer placement: a less invasive option with promising short-term results. 9) Reverse shoulder arthroplasty: for elderly patients or those with severe joint degeneration. Conclusion: Tendon repair is the preferred choice. New techniques and reverse shoulder arthroplasty require further research to enhance treatment outcomes. Comparative studies between treatment options are needed to establish optimal treatment recommendations.