The Thrower's Shoulder: Management of Full-Thickness Rotator Cuff Tears

The act of throwing places significant stresses on the rotator cuff resulting in rotator cuff injuries including rotator cuff strains, rotator cuff tendinosis, partial-thickness rotator cuff tears, and full-thickness rotator cuff tears. Full-thickness rotator cuff tears are uncommon in the young throwing athlete. It appears that most full-thickness tears are chronic injuries secondary to repetitive tensile, compressive, and shear stresses to the rotator cuff during the throwing motion. Management of full-thickness rotator cuff tears in throwing athletes is challenging. History, physical examination, imaging studies, and an understanding of the athlete's short-term and long-term goals are critical to developing a management plan for these athletes. If nonoperative treatment fails, we describe our technique for an arthroscopic rotator cuff repair using a transosseous-equivalent double-row or triple-row technique.