From the Research
Delamination of the rotator cuff refers to a specific type of tear where the tendon splits horizontally into two layers while remaining attached at both ends, as described in a recent study published in 2023 1. This condition occurs when the fibers within the rotator cuff tendons separate along their natural planes, creating a space or cleft between the articular (joint-facing) and bursal (outer) surfaces of the tendon. Some key points to consider about delamination of the rotator cuff include:
- Delamination is often missed during standard imaging and can be more challenging to repair than simple tears.
- This condition typically results from repetitive overhead activities, aging, or trauma to the shoulder.
- Patients with delaminated rotator cuff tears often experience pain, weakness, and limited range of motion in the affected shoulder.
- Treatment depends on the severity and may include physical therapy for mild cases, but more severe delamination typically requires surgical repair to reattach the separated layers, as supported by a study published in 2022 2.
- During surgery, the surgeon must address both layers of the tear to ensure proper healing, and real-time dynamic ultrasound can be a useful tool for diagnosing delaminated rotator cuff tears, with a sensitivity of 72.0% and specificity of 96.7%, as reported in a study published in 2023 3.
- Recovery involves immobilization followed by progressive rehabilitation to restore strength and function, and early diagnosis and treatment are important as delaminated tears can progress and become more difficult to repair over time. The existence of delaminated tears is a poor prognostic factor in functional and morphologic outcomes after the repair of rotator cuff tendons, as noted in the study published in 2023 1.