tor cuff tear; Group IV: cuff arthropathy. The ability to adequately manage these injuries depends on identifying their full extent during arthroscopic evaluation. 2001;32(3):443-456. We therefore confine ourselves to the most used; that of Ellman et al., which divides the thickness of the rotator cuff into three more or less equal parts, varying between 10mm and 12mm. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. distance between articular cartilage to medial footprint of rotator cuff is … 7. o a b Figure 3. The pain seems to increase with progress of the size of the tear [6, 7], mainly in adults older than 60 years with tears of grade III according to Ellman classification [1, 6, 8]. Partial tears are divided into tears of acute, chronic or acute-on-chronic onset. Ellman – Gartsman classification of full-thickness rotator cuff tears. Grade 3: Partial tear > 6mm deep. Southern California Orthopaedic Institute rotator cuff classification system. (Snyder) Comprehensive classification including the size position and quality of tendon. 2 Fraying and failure of some rotator cuff fibres in addition to synovial bursal or capsular injury. Overlap between the distal supraspinatus and infraspinatus tendons. 3. classification To classify rotator cuff ruptures and take proper deci- There are a number of classification systems that are used to describe the size location and shape of rotator cuff tears. Topography of rotator cuff tear in sagittal plane according to Patte [107] (Fig. Clin Orthop 1990;254:64-74 A novel highly porous, high purity, bioinductive implant made with reconstituted collagen fibers obtained from bovine Achilles tendon has been developed by The diagnosis is best made using an MRI Partial-thickness rotator cuff tears (PTRCTs) are most commonly classified by the RC tendons... Full-thickness tears. 2011;13(1):9-20. Rotator cuff tears, biceps rupture and bony changes. Grade 2: Partial tear 3-6 mm deep depth not exceeding one-half of the tendon thickness. a) The articular surface; b) The bursal surface: 1. Dry, wet, and resorptive. 9. Once the 4. Physical and X-ray examination, including anteroposterior and supraspinatus outlet views, were performed on both shoulders of all patients. Grade II: Partial tendon tear with a … Partial thickness rotator cuff tears were classified using the classification of Ellman (grade I-III) [19] and were divided into articular-sided (A) and bursal-sided (B) par-tial thickness rotator cuff tears. 8. Partial Thickness rotator cuff tears : Arthroscopic classification by Ellman Ellman H, CORR, (254) 64-74, 1990. Grade 3: Partial tear > 6mm deep. 2 Schematic illustration of the classification system used to describe the vertical extension of rotator cuff tears according to Ellman [18]. o a b Figure 3. SAQ results. Classification of rotator cuff tears (based upon surgical findings): Partial-thickness tears, also called incomplete tears (Ellman): Grade 1: < 3 mm deep (< 25% thickness) Grade 2: 3–6 mm in depth but not exceeding 50% of the tendon thickness Grade 3: > 6 mm deep (> 50% thickness) Full-thickness tears, also called complete tears (Cofield): Small: < 1 cm Medium: 1-3 cm a) Crescent; b) Reverse L; c) L-shaped; d) Trapezoidal; e) Massive tear; o) Normal, intact tendon. Results: MR imaging showed 80 partial-thickness and 70 full-thickness tears of the rotator cuff. Partial-thickness rotator cuff tear was described by Codman as “rim rents” in 1934, but Ellman was the first author to present a classification system that included partial rotator cuff tear. Management of Degenerative Rotator Cuff Tears. The control group consisted of … Ellman classification of partial-thickness rotator cuff tears Full-thickness tears are described in the traditional fashion with minor variations. , which may or may not be symptomatic (3). Classification Primary compressive cuff Primary tensile overload Primary internal impingement Rotator cuff failure / tear Calcific tendonitis PASTA lesions PAINT lesions Secondary compressive primary hypermobility Secondary internal impingement primary hypermobility Secondary tensile overload primary hypermobility Additional file 1 gives a Most classifications of full-thickness tears involve the superior and posterior rotator cuff. CURRENT REVIEW OFROTATOR CUFF TEARSDr. Ellman Classification of Partial-Thickness Rotator Cuff Tears Ellman H: Diagnosis and treatment of incomplete rotator cuff tears. supraspinatus is 12.7mm (covers superior facet of greater tuberosity) 6-7 mm tear corresponds to 50% partial thickness tear. The five rotator cuff tear shapes were categorized in this study: crescent, reverse L, L shaped, trapezoidal, and massive tear (Ellman Classification). Classification schemes have been developed to describe full-thickness … There are many ways to fully visualize these tears, including arm positioning and gentle debridement. The diameter of an intact tendon is 1.0–1.2 cm. Snyder classified the size of the defect by its superficial extension. Sushil Paudel 2. Southern California Orthopaedic Institute rotator cuff classification system. Ellman Classification System for the Assessment of Partial-Thickness Rotator Cuff Tears It is difficult to quantify the frequency with which partial-thickness rotator cuff tears are missed, but they can undoubtedly be a challenge to diagnose. As part of the standard diagnostic shoulder arthroscopy, the insertion of the rotator cuff on the greater tuberosity is assessed via the posterior viewing portal. Taking into account the average thickness of supraspinatus tendon, Ellman classified rotator cuff tears : grade I consists of a tear depth lower than 3 mm (or involving less than 25% of tendon thickness); grade II characterized by a depth between 3 and 6 mm or 50% of thickness; grade III involves more than 6 mm or more than 50% of thickness. Ellman H, Gartsman G, Open repair of full thickness RCT. Fig. The Ellman Classification: (left) grade I, (middle) grade II, and (grade) III. a) Crescent; b) Reverse L; c) L-shaped; d) Trapezoidal; e) Massive tear; o) Normal, intact tendon. Intra-articular findings of the rotator cuff were classified according to Ellman and Snyder. Shoulder pain is a common musculoskeletal medical condition affecting 7% to 26% of individuals and is the third most common musculoskeletal-related complaint in the primary care setting. Each rotator cuff tendon was evalu-ated according to a grading system adapted for im-aging from Ellman’s arthroscopic classification system [13]. In addition to these broader-based classifications, specific classification systems focusing on individual tendons have also been proposed. For partial-thickness tears, grade I is less than 3 mm deep, grade II is 3 to 6 mm deep, and grade III tears are more than 6 mm deep. Ellman divided partial‐thickness tears of the rotator cuff into three types according to the site of the tear: bursal side tear, articular side tear and interstitial tear (1, 2, 3) 4. grade 3 : >6 mm or >50%. The prevalence of PTRCTs ranges from 13% to 32%, which is in part correlated to patients’ age (2-4). Classification Other Section Partial-thickness tears. Massive rotator cuff tear involving two or more rotator cuff tendons, frequently with associated retraction and scarring of the remaining tendon Modified from Millstein and Snyder[ 16 ]. Shin et al [35] compared a modified Mason-Allen single row repair to a double row suture-bridge technique in 84 patients with Ellman grade 3B lesion and found similar results in both groups. Rotator cuff tears 1. One free margin of the tear has a greater mobility than the other (Figures 7 and 8). partial thickness rotator cuff tears: Clinical classification Following the description of Codman, Elmann (1990) subdivided the partial tears according to the depth of the tear (less than 3 mm, 3-6 mm and more than 6 mm) Snyder (1993) considers the width of the tear.

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