Glenohumeral instability and rotator cuff tear

• Published in: Sports medicine and arthroscopy review Vol. 19; no. 4; p. 395
• Main Authors: Porcellini, Giuseppe, Caranzano, Francesco, Campi, Fabrizio, Pellegrini, Andrea, Paladini, Paolo
• Format: Journal Article
• Language: English
• Published: United States 01.12.2011
• Subjects: Biomechanical Phenomena; Female; Humans; Joint Instability - physiopathology; Joint Instability - therapy; Male; Orthopedic Procedures - methods; Rotator Cuff - physiopathology; Rotator Cuff - surgery; Shoulder Dislocation - physiopathology; Shoulder Dislocation - therapy; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Tendon Injuries - physiopathology; Tendon Injuries - therapy
• ISSN: 1538-1951
• DOI: 10.1097/JSA.0b013e31820d583b

The prevalence of rotator cuff tears after traumatic dislocation increases with advancing age, a likely consequence of the age-associated deterioration of the structure and mechanical properties of the tendons of the rotator cuff. These are the effective stabilizers of the glenohumeral joint, compressing the humeral head in the 3-dimensional concavity of the glenohumeral joint. It is impossible to establish whether a lesion of the capsular-labrum complex or of the rotator cuff causes or follows a dislocation, regardless of whether it is anterior or posterior. A peripheral nerve or a brachial plexus injury can be associated with tendon lesion and instability, developing the "terrible triad" of the shoulder. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion.