Injury to the rotator cuff may occur due to pressure on the rotator cuff from the shoulder blade (scapula). It may occur while playing sports or due to repeated use of the arm for overhead activities. A forceful injury such as trauma can cause one or more of these tendons to tear, a condition called rotator cuff tear. The rotator cuff is a group of 4 muscles in the shoulder joint. These muscles originate in the scapula and attach to the head of the humerus through tendons. The rotator cuff forms a sleeve around the humeral head and glenoid cavity, providing stability to the shoulder joint while enabling a wide range of movements.
Rotator cuff repair is a surgery to repair an injured or torn rotator cuff. It is usually performed arthroscopically on an outpatient basis. An arthroscope, a small, fiber-optic instrument consisting of a lens, light source, and video camera. The camera projects images of the inside of the joint onto a large monitor, allowing your doctor to look for any damage, assess the type of injury and repair it. Large rotator cuff tears may require open surgery. The doctor may suggest surgery to treat rotator cuff tears if the patient does not respond to non-surgical treatment options or has severe pain and/or loss of strength in the shoulder. The surgery may also be necessary for an athlete who wants to return to sport as soon as possible.
The surgery is performed under general or regional and involves the following steps:
- One or more incisions are made at the skin near the shoulder joint.
- An arthroscope is inserted through the incision.
- Miniature surgical instruments are inserted to remove the damaged part of the tendon and injured surrounding tissue.
- The damaged ends of the tendon are sewn together. Care is taken to prevent damage to nearby nerves or blood vessels.
- A suture anchor may be used to reattach a completely torn tendon to the bone.
- The incision is closed and covered with a bandage.
Prescription pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) may be used to manage pain postoperatively. The shoulder may also be placed in a cast or brace. Specific physical therapy exercises will be recommended, and normal activities usually resume after six months.