Partial Rotator Cuff Tears in Throwing Athletes

The throwing shoulder presents many challenges for the treating orthopeadic surgeon. High functional demands, season-specific schedules, and complex pathologies make proper evaluation and treatment difficult, and accurate diagnosis is especially important in decision-making in this difficult group of patients. Adaptive changes must be differentiated from pathologic injury, and a detailed and accurate history and physical examination is crucial. Often multiple abnormalities are seen on imaging. Advanced imaging must be paired with examination to determine the specific source of dysfunction. Rotator cuff injuries in overhead athletes have proven especially difficult despite extensive research spanning many decades. Surgery in a thrower's shoulder can be disabling, and surgery must be approached with caution. Nonoperative management serves a huge role and has high success rates, but when surgery is required, diagnosis must be accurate and surgery carefully planned and executed. Multiple surgical techniques have been described, and none of the techniques have clearly demonstrated the best results. The variability of presentation and severity makes every patient different, and treatment must be specifically tailored for each patient. This article provides a review of the history of management, theories of the mechanism of injury, our surgical technique, and current surgical results. (C) 2016 Published by Elsevier Inc.