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OrthoVellum

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Sports Medicine
intermediate
X-Type

Rotator Cuff Tear - Prognostic Factors and Treatment Algorithm

Shoulder Disorders

A 62-year-old retired teacher presents with progressive right shoulder weakness and pain for 18 months. She cannot elevate her arm above shoulder level. MRI shows a 4cm full-thickness supraspinatus and infraspinatus tear with retraction to the glenoid margin. The supraspinatus fossa shows muscle signal equal to fat (Goutallier grade 3). The glenohumeral joint has early degenerative changes. The surgeon discusses prognostic factors and treatment options ranging from physiotherapy to reverse shoulder arthroplasty. Regarding rotator cuff tear management:

Mark each as TRUE or FALSE

A

Goutallier classification grades fatty infiltration on MRI: Grade 0 = no fat, Grade 1 = fatty streak...

B

Massive rotator cuff tears are defined as tears greater than 5cm in diameter OR involving two or mor...

C

All full-thickness rotator cuff tears require immediate surgical repair; conservative treatment with...

D

Retear rates after repair correlate with initial tear size: small (less than 1cm) = 10-20%, medium (...

E

Reverse total shoulder arthroplasty (RTSA) is indicated for irreparable tears with cuff tear arthrop...

Answer the questions to see explanations

Click T (True) or F (False) for each option