Rotator Cuff Arthroscopic Surgery
Even large tears can be repaired on an outpatient basis without an incision using several small arthroscopic portals. There is less pain and stiffness than with traditional open procedures.
Definition of rotator cuff: A sheet of four tendons that cover the top, front and back of the humeral head (the top of the arm bone at the shoulder). Its purpose is to hold the “ball” in the “socket” of the shoulder. The large shoulder muscles, the pectoral latissimus acovsi and deltoid, then move the arm wherever it needs to go. The supraspinatus is the rotator cuff muscle and tendon that sits atop the shoulder joint. In rotator cuff tears the supraspinatus is the principally injured tendon. The tears can then extend backward into the infraspinatus, or forward into the subscapularis tendon. Rotator cuff tears cause pain and weakness of the shoulder.
Diagnosis: At Illinois Sportsmedicine we use ultrasound to locate rotator cuff tears. Many studies have found ultrasound to be as accurate as MRI for picking up rotator cuff problems. The benefits of ultrasound include convenience, speed, cost, and patient comfort.
Rotator cuff repair: We now routinely perform this procedure arthroscopically. Surgery used to require a significant incision and overnight stay. Arthroscopic procedures are less painful and the recovery is quicker than with traditional open procedures. Small absorbable anchors are inserted into the shoulder and sutures attached to them are used to reattach the rotator cuff to the bone. Acromioplasty (see below) is usually performed at the same time. The ultimate result of the surgery appears to be about the same as after traditional open surgery.
Type of procedure: It is a minor procedure. Blood loss is negligible. Surgical time is often about two hours but may vary. The surgery is done on an outpatient basis in a hospital or surgicenter.
Definition of acromioplasty: The acromion is the bone forming the roof of the shoulder. The undersurface of it often “impinges” on the rotator cuff. In acromioplasty the undersurface of the acromion is shaved to provide more room for the rotator cuff.