Management of Rotator Cuff Pathology in 2026 (Recording)-Management of Rotator Cuff Pathology in 2026 (Recording)

Video Transcription

Video Summary

The webinar on rotator cuff pathology management in 2026 featured expert presentations covering partial to full-thickness tears, massive tears, augmentation techniques, irreparable tears, and rehabilitation strategies. Dr. Mike O’Brien detailed the spectrum of rotator cuff disease, highlighting that degeneration commonly leads to partial tears which may progress unpredictably to full-thickness tears. Conservative management with physical therapy is first-line; judicious use of cortisone injections is advised due to potential negative effects on healing. Surgical options include bioinductive collagen implants for low-grade tears, trans-tendon repairs, and takedown with repair for high-grade tears. Bioinductive implants demonstrate promising healing with accelerated rehab protocols.<br /><br />Dr. Scott Mayer focused on massive rotator cuff tears, emphasizing individualized repair strategies based on tissue quality, tear pattern, and patient factors like age and acute injury. Double-row repair is preferable where possible, while single-row with tension-reducing techniques is used when the tendon is less mobile. Rehab is tailored, often starting conservatively with delayed therapy initiation.<br /><br />Dr. Brian Waterman discussed structural and biologic augmentation options, including dermal allografts, xenografts, synthetic scaffolds, and autografts like the biceps tendon. While evidence is evolving, augmentations appear safe and may reduce retear rates, particularly for high-risk repairs. Patient selection guided by scoring systems (e.g., Rohy score) optimizes outcomes.<br /><br />Dr. Kevin Cronin addressed irreparable rotator cuff tears, underscoring the diversity in patient presentations and treatment challenges. Options range from tendon transfers (favoring lower trapezius transfer), superior capsular reconstruction, biologic tuberoplasty, balloon spacers, to reverse shoulder arthroplasty for select cases. Patient factors, including pain, function, arthritis, and expectations, guide approach selection.<br /><br />Finally, physical therapist Kevin Wilk highlighted rehabilitation principles for both non-operative management and post-surgical recovery. He emphasized pain control, posture correction, restoring motion, and dynamic stabilization with individualized protocols based on tear size and tissue quality. Neuromuscular control of the scapula and cuff muscles is critical. Early and sustained physical therapy achieves success in many cases, while advanced modalities like shockwave therapy and muscle stimulation may aid healing.<br /><br />Overall, the webinar presented a comprehensive, nuanced approach to rotator cuff management integrating surgical innovation, biologic augmentation, tailored rehab, and patient-centered decision-making.

Keywords

Rotator cuff pathology

Partial thickness tears

Full thickness tears

Rotator cuff repair techniques

Bioinductive collagen implants

Massive rotator cuff tears

Tendon transfer

Superior capsular reconstruction

Rehabilitation strategies

Biologic augmentation