Rotator Cuff Repair
The rotator cuff is the group of tendons in the shoulder joint providing support and enabling range of motion and strength of the shoulder. Rotator cuff tears are one of the most common causes of shoulder pain in middle aged adults and older individuals. They may occur with repeated use of arm for overhead activities during daily activities or while playing sports or from a traumatic injury. Rotator cuff tear causes severe pain, weakness of the arm, and crackling sensation when moving the shoulder in certain positions. There may be stiffness, swelling, loss of movements, and tenderness in certain areas of the shoulder.
A rotator cuff tear is best viewed on magnetic resonance imaging. Symptomatic relief may be obtained with conservative treatments – rest, pain medications / anti-inflammatory medications, steroidal injections and certain exercises. Surgery may be required to fix the tendon back to the shoulder bone if symptoms fail to improve with conservative measures.
Surgery to repair the rotator cuff has historically been done through a large shoulder incision, about 6-10cm long, and the deltoid muscle over the rotator cuff was separated. Minimally invasive arthroscopic surgical techniques have been developed to decrease pain, scarring, and recovery time. Arthroscopic rotator cuff repair is a minimally invasive surgery performed through small incisions, about 1 cm each, with an arthroscope.
The arthroscope is a small fiber-optic viewing instrument made up of a small lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 to 5 mm in diameter) but appear much larger when viewed through an arthroscope.
The camera attached to the arthroscope displays the image of the joint on a large monitor, allowing the surgeon to look throughout the shoulder-at cartilage, ligaments, and the rotator cuff. The surgeon can determine the amount or type of injury, and then repair or correct the problem.
The benefits of arthroscopy compared to the alternative, open shoulder surgery, include:
- Smaller incisions
- Minimal soft tissue trauma
- Ability to better visualize the entire joint.
- Lower infection rate
- Less scar tissue formation
- Earlier mobilization
- Usually performed as outpatient day surgery