{"id":10030,"date":"2025-08-28T13:13:02","date_gmt":"2025-08-28T13:13:02","guid":{"rendered":"https:\/\/www.centre-ortho.ch\/criteres-de-decision-chirurgicale-pour-les-lesions-de-la-coiffe\/"},"modified":"2025-09-07T21:18:49","modified_gmt":"2025-09-07T21:18:49","slug":"surgical-decision-criteria-for-rotator-cuff-injuries","status":"publish","type":"page","link":"https:\/\/www.centre-ortho.ch\/en\/surgical-decision-criteria-for-rotator-cuff-injuries\/","title":{"rendered":"Surgical decision criteria for rotator cuff injuries"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"10030\" class=\"elementor elementor-10030\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dac00330 conteneur_vid_0 e-flex e-con-boxed e-con e-parent\" data-id=\"dac00330\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9b00a1db conteneur_ariane_vid_0 e-con-full e-flex e-con e-child\" data-id=\"9b00a1db\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-b10e9cbd e-flex e-con-boxed e-con e-child\" data-id=\"b10e9cbd\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d362e2e8 ariane_vid_0 elementor-widget elementor-widget-breadcrumbs\" data-id=\"d362e2e8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<nav aria-label=\"breadcrumbs\" class=\"rank-math-breadcrumb\"><p><span class=\"last\">Welcome<\/span><\/p><\/nav>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-82b940f5 video_vid_1 e-flex e-con-boxed e-con e-child\" data-id=\"82b940f5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f80b03d7 video_vid_1 elementor-widget__width-inherit elementor-widget elementor-widget-video\" data-id=\"f80b03d7\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/youtu.be\\\/yH0udbl_XIk&quot;,&quot;lazy_load&quot;:&quot;yes&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-65cb3572 conteneur_principal_vid_0 e-flex e-con-boxed e-con e-parent\" data-id=\"65cb3572\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-57aed7b1 e-con-full sticky-sidebar colonne_gauche_0 e-flex e-con e-child\" data-id=\"57aed7b1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-3649e5ed e-con-full e-flex e-con e-child\" data-id=\"3649e5ed\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-70286150 elementor-widget elementor-widget-shortcode\" data-id=\"70286150\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-39788031 e-con-full colonne_vid_0 e-flex e-con e-child\" data-id=\"39788031\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-44d38a76 colonne_vid_1 pv-tv-label aleft elementor-widget-icon-box wgl-icon-box wgl-view-default button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"44d38a76\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fab-youtube\" aria-hidden=\"true\" viewbox=\"0 0 576 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M549.655 124.083c-6.281-23.65-24.787-42.276-48.284-48.597C458.781 64 288 64 288 64S117.22 64 74.629 75.486c-23.497 6.322-42.003 24.947-48.284 48.597-11.412 42.867-11.412 132.305-11.412 132.305s0 89.438 11.412 132.305c6.281 23.65 24.787 41.5 48.284 47.821C117.22 448 288 448 288 448s170.78 0 213.371-11.486c23.497-6.321 42.003-24.171 48.284-47.821 11.412-42.867 11.412-132.305 11.412-132.305s0-89.438-11.412-132.305zm-317.51 213.508V175.185l142.739 81.205-142.739 81.201z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Video type:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button no_text no_media\"><div class=\"button__content\"><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7b1a1210 colonne_vid_2 pv-tv-value aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"7b1a1210\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Clinical presentation<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1821510d e-con-full colonne_vid_0 e-flex e-con e-child\" data-id=\"1821510d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-993bdd89 colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"993bdd89\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Anatomy:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Shoulder<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6b3f186a colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"6b3f186a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Surgery:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Tendon repair; Reverse prosthesis<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-451eeb4a colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"451eeb4a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Pathology:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Rotator cuff injuries<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f7206453 colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"f7206453\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Thematic:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Surgery<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0bd76b80 e-con-full colonne_vid_0 pv-cta-card e-flex e-con e-child\" data-id=\"0bd76b80\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f5c9abe8 conteneur_spec_vid_6 elementor-widget__width-inherit aleft elementor-widget-icon-box wgl-icon-box elementor-widget elementor-widget-wgl-button\" data-id=\"f5c9abe8\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button  align-icon-left\" href=\"\/en\/consultation\/\" role=\"button\"><div class=\"button__content\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-calendar-day\" aria-hidden=\"true\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M0 464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48V192H0v272zm64-192c0-8.8 7.2-16 16-16h96c8.8 0 16 7.2 16 16v96c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16v-96zM400 64h-48V16c0-8.8-7.2-16-16-16h-32c-8.8 0-16 7.2-16 16v48H160V16c0-8.8-7.2-16-16-16h-32c-8.8 0-16 7.2-16 16v48H48C21.5 64 0 85.5 0 112v48h448v-48c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><span class=\"button__text\">Consultations<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c9b14b07 e-con-full e-flex e-con e-child\" data-id=\"c9b14b07\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ea39caab elementor-widget elementor-widget-shortcode\" data-id=\"ea39caab\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5b320e67 e-con-full conteneur_droit_vid_0 e-flex e-con e-child\" data-id=\"5b320e67\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-a241e424 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"a241e424\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f7741eb3 titre_vid_1 elementor-widget elementor-widget-heading\" data-id=\"f7741eb3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Surgical decision criteria for rotator cuff injuries<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b916c9e0 paragraphe_vid_1 elementor-widget elementor-widget-text-editor\" data-id=\"b916c9e0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tAn overview of the eligibility criteria for rotator cuff tendon surgery. Dr. Alec Cikes details the determining factors: functional age, tissue quality, type of injury, degree of retraction, and muscle condition. These factors help guide treatment toward tendon repair or another therapeutic alternative.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7d45e076 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"7d45e076\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f54cda1b tabs_vid_1 tabs-full-width-yes elementor-widget elementor-widget-wgl-tabs\" data-id=\"f54cda1b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-tabs wgl-tabs_swiper-wrapper tabs_align-justify\">\n            <div class=\"wgl-tabs_headings-wrap swiper\">\n                <div class=\"wgl-tabs_headings swiper-wrapper\"><h4 data-tab-id=\"wgl-tab_4111\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Doctors<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_4112\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Topics<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_4113\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Treatments<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_4114\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Advice<\/span>\n\n                    \n                <\/h4><\/div>\n        <\/div>\n\n        <div class=\"wgl-tabs_content-wrap\">                <div data-tab-id=\"wgl-tab_4111\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_dot list_primary_color\"><li>Dr. Alec Cikes<\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_4112\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_dot list_primary_color\"><li>Decision criteria<\/li><li> Type of injury<\/li><li> Tendon retraction<\/li><li> Muscle degeneration<\/li><li> Surgical options<\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_4113\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_check_circle list_primary_color\"><li>Rotator cuff surgery<\/li><li> Tenotomy<\/li><li> Reverse prosthesis<\/li><li> Rehabilitation<\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_4114\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_check list_primary_color\"><li>A partial lesion of more than 50% should lead to consideration of surgery<\/li><li> Muscle quality is essential for tendon repair<\/li><li> tendon retraction limits the feasibility of complete repair<\/li><\/ul>                <\/div>\n\n                    <\/div>\n        <\/div><!-- .wgl-tabs -->\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-37344c7a elementor-widget elementor-widget-shortcode\" data-id=\"37344c7a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b92a09ff e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"b92a09ff\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7a41171e titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"7a41171e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Deciding to operate on a headgear: a global and functional assessment<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-01c33c81 elementor-widget elementor-widget-text-editor\" data-id=\"01c33c81\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The surgical decision for a rotator cuff injury is not limited to age or tear size. It incorporates functional age, activity level (professional and athletic), patient expectations, and impact on daily life. Thus, an elderly but active person may require a different strategy than a sedentary young adult. Clinical assessment specifies pain, range of motion, strength, and stability, while imaging documents the type of injury and tissue quality. In this context, the objective is to identify situations where tendon repair truly improves function and pain, and those where an alternative (rehabilitation, biceps tenotomy\/tenodesis, reverse prosthesis) is more appropriate.<br><br>The discussion is conducted in a shared manner, explaining the expected benefits, the risks and the recovery schedule.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ee78585a e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"ee78585a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b7ecdbea titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"b7ecdbea\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Type of injury: partial or transfixing, and clinical thresholds<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-87e8b607 elementor-widget elementor-widget-text-editor\" data-id=\"87e8b607\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The partial or full-thickness nature of the tear determines the indication. An extensive partial lesion (often beyond approximately 50 % of the thickness) may justify surgical management if it remains painful despite well-conducted conservative treatment. Symptomatic full-thickness tears, particularly after trauma, are more likely to be repaired to restore the strength-mobility ratio. At this stage, clinical correlation is essential, as radiological size alone does not explain functional disability. Planning is based on examination and imaging to anticipate technical difficulty, postoperative protection, and rehabilitation duration.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c4012a72 e-con-full conteneur_citation_vid_0 e-flex e-con e-child\" data-id=\"c4012a72\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-47eb22f7 conteneur_citation_vid_1 aleft elementor-widget-icon-box wgl-icon-box wgl-view-default elementor-widget elementor-widget-wgl-infobox\" data-id=\"47eb22f7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-quote-left\" aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M464 256h-80v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8c-88.4 0-160 71.6-160 160v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48zm-288 0H96v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8C71.6 32 0 103.6 0 192v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h5 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-56c0705\">Tissue quality is probably the most important factor in deciding whether surgery should be indicated.<\/span><\/span><\/h5><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d481894b e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"d481894b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eb7f8175 titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"eb7f8175\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Tendon retraction and muscle degeneration: limits to repairability<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f0082fb5 elementor-widget elementor-widget-text-editor\" data-id=\"f0082fb5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The degree of tendon retraction influences the possibility of reapplying it to its bone footprint. The more marked the retraction, the more uncertain the complete repair becomes and the more exposed to the risk of excessive tension. At the same time, the muscular condition conditions recovery; advanced fatty degeneration (high grades) reduces the strength potential and durability of the repair. In this context, the decision takes into account technical feasibility, but also the foreseeable functional benefit for the patient. When these parameters are unfavorable, an alternative strategy may be preferred to avoid major surgery with uncertain results.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9bdc7779 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"9bdc7779\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0868f709 titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"0868f709\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What options are available depending on the patient\u2019s profile?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5420eb78 elementor-widget elementor-widget-text-editor\" data-id=\"5420eb78\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>In a young, active, and symptomatic patient after a traumatic rupture, tendon repair is often preferred, ideally within a reasonable timeframe. In an older patient or when the tissues are damaged, a tenotomy or tenodesis of the long biceps can provide lasting relief, particularly if the pain originates from the rotator cuff. In the presence of an irreparable cuff with marked weakness and arthropathy, reverse prosthesis becomes an option, after informed discussion. Rehabilitation remains a transverse pillar: it optimizes the shoulder before and after surgery, and constitutes in itself a complete treatment for many partial injuries.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-64367ad0 e-con-full conteneur_citation_vid_0 e-flex e-con e-child\" data-id=\"64367ad0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-11442266 conteneur_citation_vid_1 aleft elementor-widget-icon-box wgl-icon-box wgl-view-default elementor-widget elementor-widget-wgl-infobox\" data-id=\"11442266\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-quote-left\" aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M464 256h-80v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8c-88.4 0-160 71.6-160 160v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48zm-288 0H96v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8C71.6 32 0 103.6 0 192v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h5 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-56c0705\">A very retracted tendon will be more difficult to repair.<\/span><\/span><\/h5><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ae4b9bde e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"ae4b9bde\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eec844bb titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"eec844bb\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Place of rehabilitation and progression criteria<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-275cd5f2 elementor-widget elementor-widget-text-editor\" data-id=\"275cd5f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Physiotherapy first targets pain and mobility, then refocusing and motor control. Progress depends on tolerance, range of motion gained, and muscle quality. Thus, after repair, initial protection gives way to guided mobility work, then strengthening, respecting tendon healing times. In the absence of surgery, a structured program may be sufficient to restore function, with regular reassessments to confirm improvement. Coordinated monitoring between surgeon, sports physician, and physiotherapist allows for fine-tuning of intensity and schedule.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3e702209 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"3e702209\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ebe92cd9 titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"ebe92cd9\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Message to the patient: a personalized and evolving decision<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b335d37a elementor-widget elementor-widget-text-editor\" data-id=\"b335d37a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The best option is the one that corresponds to the injury, the tissue, and the life plan. Imaging provides information, but does not decide alone; clinical findings and activity guide the strategy. However, when the retraction is significant or the muscle quality is unfavorable, an alternative to repair may offer a better benefit-risk ratio. Thus, the surgical decision is a time-based one: it is prepared, reassessed after rehabilitation, and adapted to the patient&#039;s goals. This pragmatic approach secures recovery and maximizes return to function.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-07ba9391 e-con-full conteneur_tags_0 e-flex e-con e-child\" data-id=\"07ba9391\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5d4b6488 conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"5d4b6488\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/rotator-cuff-surgery\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">rotator cuff surgery<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-701dfe05 conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"701dfe05\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/operational-criteria\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">operating criteria<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ab9bc7b conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"3ab9bc7b\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/dr-alec-cikes\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">Dr. Alec Cikes<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f60cb3d3 conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"f60cb3d3\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/retracted-tendon\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">retracted tendon<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f188b3c conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"5f188b3c\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/winemaker\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">winemaker<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-05e5d441 e-con-full e-flex e-con e-parent\" data-id=\"05e5d441\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-082addc1 elementor-widget elementor-widget-shortcode\" data-id=\"082addc1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ec20b59d e-con-full e-flex e-con e-parent\" data-id=\"ec20b59d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3ebb949e elementor-widget elementor-widget-shortcode\" data-id=\"3ebb949e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-68025a33 e-con-full e-flex e-con e-parent\" data-id=\"68025a33\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b8d97fdb elementor-widget elementor-widget-shortcode\" data-id=\"b8d97fdb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Presentation of the eligibility criteria for rotator cuff tendon surgery. Dr. Alec Cikes details the determining factors: functional age, tissue quality, type of lesion, level of retraction, and muscle condition.<\/p>","protected":false},"author":1,"featured_media":14950,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[76],"tags":[233,234,235,237,236],"class_list":["post-10030","page","type-page","status-publish","has-post-thumbnail","hentry","category-videos","tag-chirurgie-coiffe-des-rotateurs","tag-criteres-operatoires","tag-dr-alec-cikes","tag-goutalier","tag-tendon-retracte"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages\/10030","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/comments?post=10030"}],"version-history":[{"count":0,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages\/10030\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/media\/14950"}],"wp:attachment":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/media?parent=10030"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/categories?post=10030"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/tags?post=10030"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}