A rotator cuff tear is a common injury that causes pain, stiffness and weakness in the shoulder. Some rotator cuff tears can be treated non-surgically with rest, activity restriction, medication and physical therapy. But for severe injuries, surgery may be necessary to successfully repair the damage.
The rotator cuff consists of a network of muscles and tendons (the strong fibers that connect our muscles to our bones) which surround the shoulder joint. They form a “cuff” over the head of the humerus (upper arm bone) to keep it securely in place within the shallow socket of the shoulder. The rotator cuff allows and controls movement of the arm and shoulder.
The rotator cuff can be vulnerable to injury, particularly during sports involving overhead throwing motion, such as pitching in baseball or playing tennis, and in jobs that involve excessive overhead arm movements or heavy lifting, such as construction. The aging process increases the risk of rotator cuff tears because tendons and muscles degenerate and weaken over time. Sudden shoulder movements, a fall, or overuse can also cause this type of injury.
Rotator Cuff Repair Surgery
Surgery may be recommended for painful, acute tears, if non-surgical treatments have failed to work successfully, or for people who rely on arm strength for work or playing sports.
There are several surgical options that can be used to repair rotator cuff tears. The size, shape, and location of the tear will determine the most appropriate type of surgery. Many rotator cuff repair surgeries can be carried out as outpatient procedures and the procedure will require either a general or regional anesthetic.
For partial rotator cuff tears, a debridement procedure which simply trims the tendon and removes the damaged tissue may be all that is required. But for complex tears, surgery to reattach the tendons to the upper arm bone is often necessary.
There are three common surgical approaches for rotator cuff repair surgery which include:
Arthroscopic Repair Surgery
An arthroscopy allows a surgeon to view, diagnose, and treat rotator cuff damage using miniature surgical instruments and a viewing scope which are inserted through very small incisions approximately ¼” to ½” in length. It can also be used to reconstruct ligaments or remove damaged tissue and bone spurs. The arthroscope is about the size of a pencil and contains a lens and lighting system allowing the surgeon to view inside the joint. It can be attached to a miniature camera enabling the surgeon to view magnified images on a video screen or take photographs and record videotape. Arthroscopic repair surgery does not require the joint to be opened up fully and is a less invasive procedure compared to open repair surgery which requires larger incisions. It also has less risk of infection, a shorter recovery period, and because the surgical incisions are so small, they only require a few stitches or Steri-Strips, which are then covered with a bandage.
Open Surgical Repair Surgery
Open surgical repair is the more traditional type of surgery. It is usually required for larger or more complex tears and requires a larger incision than arthroscopic repair. An incision is made over the shoulder and a small portion of the large deltoid muscle on the shoulder is detached in order to carry out the surgery. Sometimes, a procedure known as an acromioplasty is performed at the same time to remove bone spurs from the surface of the bone (acromion) which may be causing friction or damage to tendons.
Mini-Open Repair Surgery
A mini-open repair uses much smaller incisions (typically three to five cm. in length) than open surgical repair, and the deltoid muscle does not need to be detached. The surgeon uses an arthroscope to assess and repair the damage and to remove bone spurs under the acromion and treat other structures in the shoulder joint. Typically, the results of this type of procedure are equal to the open repair surgical method.
Shoulder Pain Experts in Maryland
If you are experiencing shoulder pain, contact Greater Chesapeake Hand to Shoulder today. Our specialists are dedicated to relieving shoulder pain and movement limitations to help you get back to your normal activities as soon as possible. If you would like to find out more about services or schedule an appointment, call our Maryland shoulder surgeons at (410) 296-6232 or you can request an appointment online.
