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Appropriate Use Criteria
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Appropriate Use Criteria
2020-01-08T18:06:15+00:00
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GUIDELINE
APPROPRIATE USE CRITERIA: MANAGEMENT OF ROTATOR CUFF PATHOLOGY 2025
INDICATION PROFILE
Tear Size
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C1-C2: Small or Medium full-thickness defect <3cm in any direction
C3: Large, full-thickness defect 3-5 cm in any direction
C4: Massive rotator cuff tear involving two or more rotator cuff tendons, greater than 5 cm
Presentation
Acute Traumatic Tear, without evidence of degeneration on imaging (within approximately 2 months)
Acute Event on Chronic Degenerative Tear
Chronic
Symptom Severity
Mild Symptom Severity
Moderate Symptom Severity
Severe Symptom Severity
Identifiable Factors That Negatively Affect Healing or Outcomes
Identifiable Factors that Negatively Affect Healing or Outcome Present
No Identifiable Factors that Negatively Affect Healing or Outcome
Atrophy/Fatty Infiltration
G 0-2
G 3-4
Response to Previous Treatment
No Response to Previous Treatment
No Prior Treatment
PROCEDURE RECOMMENDATIONS
Treatment recommendations are not available for this patient scenario.
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