Rotator Cuff and Rotator Cuff Tears: Treatment Options
Anatomy of a Healthy Shoulder
Injuries of the Rotator Cuff
Rotator cuff tears is a common shoulder injury that causes pain and disability. In 2008, close to 2 million people in the United States saw a physician because of a rotator cuff problem.
A torn rotator cuff can be very painful and make even the most simple, day to day tasks difficult. Many rotator cuff injuries can be treated through resting the joint, medication and physical therapy.
When Rotator Cuff Surgery is Recommended
If the pain becomes constant or increases with intensity and the condition of the joint worsens or you are physically active, then surgery may be indicated.
Other signs that surgery may be a good option for you include:
- Your symptoms have lasted 6 to 12 months
- You have a large tear (more than 3 cm)
- You have significant weakness and loss of function in your shoulder
- Your tear was caused by a recent, acute injury
Rotator Cuff Surgical Options
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of your upper arm bone or the humerus.
Another type of tear is the partial tear. This tear may not need a full re-attachment of the rotator cuff tendon and may involve only need to be trimmed. This procedure is called a debridement. A complete tear within the thickest part of the tendon is repaired by stitching the two sides back together.
Advancements in surgical techniques have given rise to less invasive surgical techniques.
The type of repair performed depends on several factors:
- surgeon’s experience
- surgeon’s familiarity with a particular procedure
- size of your tear
- your anatomy
- quality of the tendon tissue and bone
The three techniques most commonly used for rotator cuff repair include traditional open repair, arthroscopic repair, and mini-open repair.
Open repair is a traditional open surgical incision where the skin of the shoulder is cut open to reveal the injured tendon. This type of surgery is usually performed if the tear is large or complex or if additional reconstruction, such as a tendon transfer, is indicated.
Arthroscopic repair is considered less invasive or minimally invasive and is accomplished through the use of cameras (arthroscope), a television screen and specifically designed surgical instruments. arthroscopic surgery typically results in smaller cuts or incisions, less impact on the deltoid muscle and shorter times to full recovery.
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