Arthroscopic Rotator Cuff Repair
What is the Rotator Cuff?
The Rotator Cuff is the group of four tendons in the shoulder joint providing support and enabling wider range of motion. Injury or “wear and tear” to the tendons may result in a tear, this condition is called a Rotator Cuff Tear. It is one of the most common causes of shoulder pain in middle aged adults and older individuals.
Rotator Cuff Tears are often associated with other shoulder problems such as:
What causes a Rotator Cuff Tear?
Rotator Cuff Tears can occur from a traumatic injury to your shoulder or from “wear and tear”. As we get older the quality of our tendons diminishes and become more predisposed to tearing. The Rotator Cuff tendons most commonly tear off their bone insertion.
The degenerative tears are often caused my “shoulder impingement” where the tendon is crushed by the overlying part of the shoulder blade, the acromion.
The traumatic tears result from forceful tearing of the tendon off the bone. For example from a fall.
What are the symptoms of a Rotator Cuff Tear?
Like many conditions there is a spectrum of severity. The symptoms are similar.
Rotator Cuff Tears usually cause pain and weakness. This can vary from a complete inability to lift your arm to subtle weakness only noticed on testing. Similarly, the pain can vary from severe constant pain to pain only with particular movements and positions.
The pain is usually localised to the side or the front of the shoulder.
How do you Diagnose a Rotator Cuff Tear?
Diagnosis is usually base on your symptoms and a thorough examination. Rotator Cuff Tears are often associated with other shoulder problems such as:
We would then usually obtain an MRI of your shoulder to confirm our diagnosis and provide more detail about the tear. Rotator Cuff Tears are best viewed on an MRI scan and provide exquisite detail including the location, size and chronicity of the Rotator Cuff Tear.
How do you treat Rotator Cuff Tears?
Rotator Cuff Tears can vary in size and location. This will dictate treatment.
Most small to medium tears can be treated non operatively first, these are rarely time sensitive. But large or massive rotator cuff tears often require surgery and are time sensitive. If a large of massive tear is not repaired within 3 – 6 months the tendons will retract and the muscle will waste away leaving it potentially irreparable.
Non-operative treatment of rotator cuff tears is multimodal. It involves:
It may take a few months to see benefit from non operative treatment. Failure to improve or for large size tears will require a Rotator Cuff Repair.
What is an Arthroscopic Rotator Cuff Repair?
If you require a rotator cuff repair, Dr Nandapalan will perform this Arthroscopically (keyhole). The surgery involves using a series of bone anchors and tape to anchor the tendon back down to its bone insertion. In doing so the “footprint” of the Rotator Cuff tendon is re-established.
While the tendon is anchored to the bone your body will heal the tear over the following 3 months.
During the surgery other associated problems such as the following will also be addressed:
The surgery will usually take 30 to 60 minutes. It can be performed as day surgery or with an overnight stay. Post-operatively you will be in a sling for 4-6 weeks depending on the size of your rotator cuff tear during which time you will commence Physiotherapy and follow Dr Nandapalan protocol. Once again depending on the size of the tear your shoulder with take 3-6 months to recover.