Rotator cuff repair

Rotator cuff repair is a surgical procedure used to treat tears and other injuries of the rotator cuff, a part of your shoulder that helps move and stabilize your arms. It may consist of shaving off bone spurs that are pinching the shoulder, or repairing torn rotator cuff tendons and/or torn muscles in the shoulder.

Approximately 50 percent of people with rotator cuff injuries have pain relief and improved function as a result of nonsurgical treatments. Unfortunately, shoulder strength seldom improves without surgery. If your pain continues after you have used nonsurgical treatments for several months, you are a candidate for rotator cuff repair surgery. Other reasons surgery may be your best options are:

• You use your arms for overhead work or sports.
• Chronic shoulder and arm pain have lasted for more than six months.
• You want to restore your arm and shoulder to its full strength (not always attainable with nonsurgical treatments).
• You have a large tear in your tendon or muscle (more than three centimeters).
• Your tear was caused by a recent, acute injury.

Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of the humerus (upper arm bone). During your surgery, your surgeon may also be able to repair any other shoulder problems such as osteoarthritis, bone spurs or other soft tissue tears.

Advancements in surgical techniques have led to less invasive procedures, such as arthroscopic surgery. Many types of rotator cuff repair can be performed on an outpatient basis. The three main types of rotator cuff repair surgery are:

• Open repair surgery—The first surgical technique to repair torn muscles and tendons, open rotator cuff repair surgery involves a surgical incision a few inches long. Your orthopedic surgeon then detaches the shoulder (deltoid) muscle to access the torn tendon. During open repair surgery, your surgeon may also remove bone spurs from the underside of the acromion, the outer end of the shoulder blade (scapula) to which the collarbone is attached. This surgical method is often required if the tear is large or complex and involves additional reconstruction such as a tendon transfer.
• Shoulder arthroscopy repair surgery—Your surgeon inserts a thin camera (arthroscope) into a very small incision in your shoulder joint to see inside the joint. The camera transmits pictures to a monitor screen which guides the surgeon's miniature surgical instruments in performing the surgery.
• Mini-open repair—Mini-open repair surgery (a combination of arthroscopy and open surgery) removes bone spurs arthroscopically without having to detach the deltoid muscle. Your surgeon then repairs the rotator cuff directly through a mini-open incision.