Rotator Cuff Repair

Understanding Rotator Cuff Repair

Rotator cuff tears may develop because of an acute injury, but are most often caused by age-related degeneration or chronic impingement (rotator cuff tendons being pulled and squeezed under the coracoacromial arch). Cuff tears can be diagnosed clinically, but MRI is used to determine the extent of the tear and further management. Partial thickness tears are initially treated with conservative management including physical therapy, NSAIDs and activity modification. If the patient fails with conservative management or has a full thickness tear that is causing significant pain and disability they may be a candidate for arthroscopic repair of the rotator cuff.

Torn Rotator Cuff on MRI

Intact Rotator Cuff on MRI

Arthroscopic Rotator Cuff Repair

Shoulder arthroscopy involves introducing a small camera and instruments into the shoulder joint to examine different parts of the shoulder. This may oftentimes be both therapeutic and diagnostic. Arthroscopy allows the surgeon to visualize the labrum, biceps tendon, capsular ligaments, undersurface and superior surface of rotator cuff, the glenoid, humeral head, and subacromial space. Debridement and repair of injured structures can be done when necessary through the small portals made in the shoulder. The overall goal is to restore normal function and stability while eliminating pain.
Rotator cuff repairs involve returning the torn tendon to its native location with the use of anchors placed in the bone and sutures drawn through the torn end on the tendon. The tendon will take about 6 weeks to heal down to the bone and not until 3 months after surgery is it safe to do any kind of resistance or strengthening of the shoulder. Physical therapy for range of motion will begin 6 weeks after surgery and you can expect the entire recovery process to take anywhere from 6 months to 1 year after surgery.

Arthroscopic rotator cuff repair