Understanding and Addressing Rotator Cuff Tears

The rotator cuff is a vital part of our anatomy, a complex network of muscles and tendons that provides stability and facilitates a full range of motion to the shoulder joint. It comprises four muscles and their associated tendons, which can become partially or entirely torn due to overuse or injury, leading to a condition known as a rotator cuff tear.

What are rotator cuff tears?

A rotator cuff tear primarily occurs due to prolonged overuse of the muscles, making it more prevalent in patients over the age of 40. However, it can also result from traumatic injuries.

Symptoms may include:

  • Pain when lifting or lowering the arm
  • Muscle weakness
  • Atrophy
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Non-surgical treatment options

Many rotator cuff tears can be treated non-surgically. These treatments aim to alleviate pain and restore function to the shoulder. They may include:

  • Rest
  • Use of a sling
  • Anti-inflammatory medication
  • Steroid injections
  • Physical therapy

However, surgery may be recommended for tears that cause severe pain or do not respond to these conservative treatments. The type of surgery performed depends on the size and location of the tear and often involves trimming torn edges or suturing the tendon back together.

What is the procedure for rotator cuff repair?

Rotator cuff surgery may be performed arthroscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area.

Arthroscopic rotator cuff repair

Arthroscopy is a surgical procedure used by orthopaedic surgeons to visualize, diagnose, and treat problems inside a joint. The word “arthroscopy” comes from two Greek words, “arthro” (joint) and “skopein” (to look), and together they mean “to look within the joint.” During an arthroscopic rotator cuff repair, the surgeon makes several small incisions around the shoulder. A thin tube known as an arthroscope, equipped with a light and a tiny camera, is inserted into one of these incisions. This camera projects images onto a television monitor, allowing the surgeon to see the internal structures of the shoulder in detail.

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Advantages of arthroscopic surgery

The advantages of arthroscopic surgery over traditional open surgery include less pain after the operation, less scarring, and typically a shorter recovery time. However, the procedure requires a high degree of technical skill, and it may not be the best option in every case, particularly when the damage involves large or complex tears.

Our skilled surgeons will discuss the best treatment options for you based on the size, shape, and location of your rotator cuff tear, your age, your activity level, and your overall health.

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Open rotator cuff repair

Open rotator cuff repair is a traditional surgical approach that may be recommended in cases of large or complex rotator cuff tears. This procedure provides the surgeon with a broad view and direct access to the shoulder structures, which can be particularly beneficial in treating more severe conditions. The procedure begins with the surgeon making a single large incision over the shoulder joint. In order to gain access to the torn tendon, the deltoid muscle — the large, rounded, triangular muscle located on the uppermost part of the arm and shoulder — is gently detached.

This allows the surgeon to have a clear and direct view of the damaged rotator cuff. Once the rotator cuff is fully visible, the surgeon removes any bone spurs or degenerated portions of the tendon, which may be contributing to the pain or limiting movement. The healthy edges of the torn tendon are then carefully stitched back together and reattached to the humerus (upper arm bone) using sutures. If necessary, small rivets (called suture anchors) are inserted into the bone to hold the tendon in place as it heals.

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Advantages to open rotator cuff repair

Superior visualization

The open method gives the surgeon a direct and unobstructed view of the damaged tissue, allowing for precise surgical repair.

Treatment of complex tears

Open repair is often preferred for large or complex tears, as well as in cases where additional procedures, such as a shoulder replacement, are required.

Durability of repair

Some research suggests that open repair may result in a lower rate of re-tears compared to less invasive methods.

It is worth noting that recovery from open surgery may take longer than with minimally invasive procedures, and a more intensive physical therapy regimen may be required to regain full shoulder function. Your doctor will thoroughly discuss the potential risks and benefits with you, as well as your specific condition, overall health, and lifestyle, to determine the most appropriate treatment option.

Post-surgery and rehabilitation

Once the repair is complete, any incisions will be stitched closed, and you will be moved to a recovery room, where you will be monitored post-operatively for a few hours.

Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. Approximately 80 to 95 percent of patients achieve effective pain relief, restoration of function, and improved range of motion after their procedure.

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What is the recovery for rotator cuff repair?

Recovery time depends on the type of surgery but can take several months. After surgery, the arm will be immobilized to promote proper healing. Physical therapy will begin shortly after surgery to help restore strength and movement and allow you to resume their regular activities gradually. It is essential to commit to their physical therapy program in order to achieve the most effective surgical results.

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Arthroscopic rotator cuff repair video

For those interested in seeing the process in action, we offer a video walkthrough of an arthroscopic rotator cuff repair.

Why choose NY Sports & Joints Orthopaedic Specialists for rotator cuff repair?

When it comes to your rotator cuff repair, choosing our medical team means entrusting your health to some of the most highly trained and board-certified surgeons in the field.

Our team, with prestigious degrees from top-tier schools such as Princeton, Stanford, Harvard, Cornell, and Columbia, are not only experts in their field but also pioneers of the latest advances and most precise techniques available for rotator cuff repair.

Their dedication extends beyond their impressive academic credentials and into their real-world applications. We are a multi-disciplinary team with a single focus: restoring you back to your health, mobility, and lifestyle.

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