Rotator Cuff Tear and Repair
The rotator cuff consists of a group of muscles and tendons surrounding the shoulder joint holding the shoulder in place. It holds firmly the head of the upper arm bone within the shallow socket of the shoulder. The rotator cuff attaches the humerus to the shoulder blade and aids in lifting and rotating the arm.
An injury to the rotator cuff can develop over time due to repetitive actions or may happen suddenly when falling on outstretched arms. Ageing is also a factor for rotator cuff degeneration and tears. Rotator cuff injuries occur often in people performing repetitive overhead motions at their jobs as in carpenters, painters, etc. Sports involving repetitive overhead motions can also trigger rotator cuff injuries, example playing tennis or baseball.
Rotator cuff damage may be due to:
- Rotator cuff strain or tears
- Tendinitis of the shoulder (Tendon inflammation)
- Bursitis in the shoulder (Inflammation of the bursa)
Symptoms of Rotator cuff injury include recurrent pain, restricted range of motion of the arm, muscle weakness.
Medical treatments for rotator cuff injury includes:
- Steroid injections
- Physical Therapy and Stretching and Strengthening Exercises
- Non-steriodal antiinflammatory medicines
- Avoidance of activities that cause shoulder pain
Surgical Treatment of Rotator Cufff Tear
Surgical correction of a rotator cuff tear involves reattaching the tendon to the upper arm bone or humerus. Correction of a partial tear may involve a smoothing procedure called debridement. Rotator cuff surgery is recommended if your pain does not subside with nonsurgical methods. Persistent pain is one the main indications that you may need surgery. You may also need to undergo surgery if you are actively involved in overhead work or sports.
Other signs that you may consider surgery for rotator cuff includes
- Tear was caused recently due to an acute injury.
- There is significant weakness causing loss of fuction and range of motion restricting the activities of daily living
- Symptoms lasting 6 to 12 months
Surgical Repair Options
Most common techniques used for Rotator cuff Repair includes Open Repair and Arthroscopic Repair
In Open Repair an open incision is made which is several centimeters long. The surgeon removes bone spurs from the underside of the acromion called acromioplasty during an open repair. Advancement in medical science has led to less invasive procedures for rotator cuff repair.
In arthroscopic repair, the repair is performed by the surgeon by inserting a small camera, called an arthroscope, into your shoulder joint. Pictures are displayed by the camera on a television screen, and these images guide the surgeon to use miniature surgical instruments. The incisions made are very small as the arthroscope and surgical instruments used are very thin. Thus Arthroscopic Repair is advantageous compared to Open Repair where larger incisions are needed. Arthroscopic repair is an outpatient procedure and a least invasive method.