What is rotator cuff repair?
The shoulder joint is comprised of three bones: the upper arm bone (humerus), the collarbone (clavicle) and the shoulder blade (scapula). The “ball” (head of the humerus bone) of the upper arm bone rests in the “socket” region of the shoulder blade called the glenoid. A rim of soft fibrous tissue called the labrum surrounds the glenoid to help stabilize the joint by allowing the “ball” to fit more securely into the “socket.” In addition, this tissue serves as an attachment site for several ligaments. Tears to this tissue result in instability of the shoulder joint.
Symptoms of a rotator cuff tear may include:
- Pain when lifting or lowering the arm
- Thinning of the muscles about the shoulder
- Weakness when lifting or rotating the arm
- Crackling sensation when moving the joint
Injuries to this tissue may result from acute trauma or repetitive motion in the shoulder. Examples of trauma include a direct blow to the shoulder, falling on an outstretched arm, or a sudden pull when lifting a heavy object. Diagnosis of shoulder instability involves a physical examination to check range of motion, stability and pain, as well as an X-ray, CT or MRI. Tears to this tissue can be located above or below the middle of the glenoid socket, and sometimes show a correlation with full or partial shoulder dislocation.
Non-surgical treatments typically include strengthening exercises to increase range of motion, anti-inflammatory medication, steroid injection as well as rest and activity modification. Surgical treatment is recommended for injuries to the rotator cuff that do not respond to non-surgical methods and involve weakness, loss of function, and pain. The nature of the injury will determine the type of surgery, although most tears can be repaired arthroscopically. Partial tears will involve a trimming or smoothing procedure called “debridement,” while full tears will involve suturing the two sides of the tendon back together. Tendons torn away from their insertion onto the upper arm bone (humerus) will need to be reattached.