Rotator Cuff Tear
The rotator cuff is a group of tendons that connects the four muscles of the upper shoulder to the bones .The strength of the cuff allows the muscles to lift and rotate the humerus The tendons run under the acromion (part of the shoulder blade) where they are very vulnerable to being damaged. This can lead to a tear resulting in a painful, weak shoulder. A tear may result suddenly from a single traumatic event or develop gradually. When the tendons or muscles of the rotator cuff tear, the patient is no longer able to lift or rotate his or her arm with the same range of motion as before the injury and/or has significant pain associated with shoulder motion. The pain is also very commonat night, often radiating down the arm.
Treatment recommendations vary from rehabilitation to surgical repair of the torn tendon(s). The best method of treatment is different for every patient.
- Activity modification (avoidance of activities that cause symptoms).
- Analgesics and anti- inflammatory
The three commonly used surgical techniques for rotator cuff repair are
- Open repair
- Mini-open repair
- All-arthroscopic repair
Mini-open repair is an arthroscopic assisted open surgery. This technique incorporates arthroscopy to visualize the tear and assess and treat damage to other structures within the joint and remove the spurs under the acromion. Once the arthroscopic portion of the procedure is completed, the surgeon proceeds to the mini-open incision to repair the rotator cuff. The incision is typically 3 cm to 5 cm in length. Currently, this is one of the most commonly used methods to treat large tear of the rotator cuff.
An arthroscopic repair is done by the surgeon looking through the arthroscope. This is a more recent method in the treatment of rotator cuff tears, and it is best suitable for small tears.