What causes a rotator cuff tear?
There are two main causes of rotator cuff tears: injury, or acute, and degenerative.
- Acute Tear- A fall on an outstretched arm or lifting an overly heavy item with a jerking motion, can tear the rotator cuff. A tear can also occur with a broken collarbone or dislocated shoulder.
- Degenerative Tear- Most tears occur because the tendon has worn down over time, common with aging. The dominant arm is usually more susceptible. If you have a degenerative tear in one shoulder, it is more likely to tear the opposite shoulder. Different factors can contribute to degenerative tears such as repeating the same motions over and over again. Baseball, tennis, rowing, and weightlifting can put a person at risk for overuse tears.
- Additionally, several jobs and chores can cause overuse tears. As a person ages, the blood supply in the tendons also diminishes. This impairs the body's natural ability to repair it, ultimately leading to a tear. As a person gets older bone spurs can also develop. Lifting the arm causes the tendon to rub on the spur. This is called shoulder impingement. This weakens the tendon, making it even more susceptible to tearing.
What treatments are there?
To treat a rotator cuff injury, the doctor will often begin with non-surgical options such as resting the shoulder, avoiding activities which cause the pain, NSAIDs or other anti-inflammatory drugs, physical therapy and stretching exercises, or steroid injections into the joint. However, when these do not provide adequate relief surgical treatment can be necessary.
What is Rotator Cuff Surgery?
Surgery can be employed to address a torn rotator cuff when the injury is very serious or if non-surgical treatment has not been successful. It can improve shoulder strength and range of motion satisfactorily. Surgery to fix a torn rotator cuff tendon typically entails:
- Extracting loose fragments of bursa, tendon, and other debris from the area of the shoulder where the rotator cuff turns.
- Making additional room for the rotator cuff tendon so that it is not irritated or pinched. If required, this will include shaving the bone or removing bone spurs from the end of the shoulder blade.
- Sewing together tore edges of the supraspinatus tendon and to the top of the upper arm bone.
Arthroscopic surgery is the most common. However, the surgeon may need to perform Open-shoulder surgery for severe cases.
What is arthroscopic shoulder surgery?
Shoulder arthroscopy is a minimally-invasive procedure which uses a small scope mounted camera to visualize the interior of the joint during surgery. Unlike traditional open surgery that requires a large incision, Shoulder Arthroscopy uses one or more very small incisions in strategic places and allows for a much faster recovery.
What conditions can shoulder surgery treat?
Shoulder surgery can be used to address numerous conditions which affect a person’s ability to move their shoulder freely including:
- Bursitis or Tendonitis
- Impingement and partial rotator cuff tear
- Full-thickness rotator cuff tear
- Instability
- Fractured collarbone
- Acromioclavicular joint separation
- Fractured head of the humerus
- Osteoarthritis
- Rheumatoid arthritis
What happens during the procedure?
Initially, the surgeon will make a few small incisions in the shoulder, and a sterile solution will rinse and fill the joint. This helps the surgeon to observe the shoulder clearly and in detail. The surgeon can properly diagnose the issue by studying the joint. An arthroscope will be inserted and the picture projected on a TV so he can see the joint and his tools to complete the procedure. The doctor will then insert specially designed instruments through small incisions and perform the repairs or removals. These instruments can include scissors, motorized shavers, or lasers. The procedure usually lasts between 30 minutes and an hour, depending on the extent of the necessary repairs. Once the repairs or removal are complete, the surgeon will close the incisions with either a stitch or a sterile strip. Then these will be protected with a bandage.
What’s the Difference Between Arthroscopic Surgery and Traditional Surgery?
Traditional surgery requires a large incision that exposes the joint so the surgeon can see it. This means more trauma to the tissues, more post-operative pain, a larger scar, and a longer recovery time. Shoulder Arthroscopy uses very small incisions—around half an inch long—which means far less trauma. Arthroscopic surgery results in less scarring, lower risk of infection due to the smaller incision, less post-operative pain, and a shorter recovery time.
