geometric classification rotator cuff tears james davidson, md steve burkhart, md phoenix san...
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Geometric ClassificationRotator Cuff Tears
Geometric ClassificationRotator Cuff Tears
James Davidson, MD Steve Burkhart, MD
Phoenix San Antonio
Previous Classifications
Do not achieve these goals No current Standard Do not utilize three dimension info derived
from MRI and Arthroscopy
McLaughlin
LESIONS OF THE MUSCULOTENDINOUS CUFF OF THE SHOULDER BY HARRISON L. McLAUGHLIN, M.D., NEW YORK, N. Y.
From the Fracture Service of the Presbyterian Hospital in New York, and the Department of Surgery, the College of Physicians and Surgeons, Columbia University
THE JOURNAL OF BONE AND JOINT SURGERY JANUARY 1944
Dr.
A. Transverse
B. Longitudinal
C. Retracted
Geometric ClassificationRotator Cuff Tears
A System Linking Tear Pattern
to
Treatment and Prognosis
Arthroscopy Current Concepts In Press, 2009
Foundation
Burkhart, Adams, Arrigoni, Barth, Brady,
Huberty, Lo, Parten, Pearce, Richards,
Tehrani, Tauro, and others
Geometric ClassificationType Description Preoperative MRI Treatment Prognosis
1 Crescent Short - Wide Tear End to bone Good to Excellent
2 Longitudinal (L or U) Long –Narrow Tear Side to Side Good to Excellent3 Massive Contracted Long and Wide Interval slides/
Partial repair Fair to Good
4 Cuff Tear Arthropathy Loss of AHI, DJD Irreparable Arthroplasty
Variable
Massive Contracted
L ≥ 2cm; W ≥ 2cm most require slides/partial L ≥ 3cm; W ≥ 3cm all require slides/partial
Rotator Cuff Arthropathy Loss of Acromiohumeral Interspace Glenohumeral Arthrosis Irreparable by Scope or Open Arthroplasty if Surgery
Additional NotationsRelated Pathology
Subscapularis Biceps Labrum Instability Arthritis AC or GH Fatty Degeneration
Geometric ClassificationType Description Preoperative MRI Treatment Prognosis
1 Crescent Short - Wide Tear End to bone Good to Excellent
2 Longitudinal (L or U) Long –Narrow Tear Side to Side Good to Excellent3 Massive Contracted Long and Wide Interval slides/
Partial repair Fair to Good
4 Cuff Tear Arthropathy Loss of AHI, DJD Irreparable Arthroplasty
Variable
Geometric Classification
Improved Communication Guidance re Treatment Guidance re Prognosis Meaningful Comparison