Complex shoulder disorders: Evaluation and treatment

Pietro M. Tonino, Christian Gerber, Eiji Itoi, Giuseppe Porcellini, David Sonnabend, Gilles Walch

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Evaluation of patients with shoulder disorders often presents challenges. Among the most troublesome are revision surgery in patients with massive rotator cuff tear, atraumatic shoulder instability, revision arthroscopic stabilization surgery, adhesive capsulitis, and bicipital and subscapularis injuries. Determining functional status is critical before considering surgical options in the patient with massive rotator cuff tear. When nonsurgical treatment of atraumatic shoulder stability is not effective, inferior capsular shift is the treatment of choice. Arthroscopic revision of failed arthroscopic shoulder stabilization procedures may be undertaken when bone and tissue quality are good. Arthroscopic release is indicated when idiopathic adhesive capsulitis does not respond to nonsurgical treatment; however, results of both nonsurgical and surgical treatment of posttraumatic and postoperative adhesive capsulitis are often disappointing. Patients not motivated to perform the necessary postoperative therapy following subscapularis repair are best treated with arthroscopic debridement and biceps tenotomy.

Original languageEnglish
Pages (from-to)125-136
Number of pages12
JournalJournal of the American Academy of Orthopaedic Surgeons
Issue number3
Publication statusPublished - 2009 Mar
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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