Rotator Cuff Tear & Repair
The shoulder joint is one of the most flexible ones in the body. The structure of this joint makes it possible to carry out a wide range various movements in the upper limbs. It combines the tendons of the supraspinatus, infraspinatus, and small round muscles. Despite the difference in their functions, such an anatomically close place of muscle fixation allowed traumatologists to identify them into a common group.
The rotator cuff tear can be considered a rupture of one or a group of tendons that make up it. Most often it is caused by trauma, dislocation, or previous chronic inflammation. This condition calls for on-time rotator cuff repair.
The rotator cuff tear is always accompanied by a sharp attack of pain localized in and around the shoulder joint. The aching often radiates to the hand, neck and forearm. A characteristic symptom is increased pain when trying to make a certain movement of the hand, for example, to raise it or take it to the side. In some cases, patients are completely deprived of the ability to move their arm. The individuality of the symptoms and the degree of their severity depends on whether the rotator cuff tear was complete or partial. Patients also very often complain about the inability to sleep on the side where the joint is damaged.
A fairly common cause of the rotator cuff tear is chronic tendon trauma. Basically, this applies to people whose professional activities are associated with hard physical labor. Severe stress on the joints, accompanied by repeated movements, leads to chronic inflammation and pain.
Treating a Rotator Cuff Tear & Repair
The initial treatment for an acute, recent rotator cuff tear is pain relief. As a rule, non-steroidal anti-inflammatory drugs are used in the rotator cuff repair. Also, in the acute period, it is necessary to keep the sore hand at rest. It is immobilized on a kerchief bandage or on a special abduction splint.
When is Rotator Cuff Surgery Necessary?
The rotator cuff surgery is indicated in the following cases of the rotator cuff tear:
- there is a complete gap that makes movement in the shoulder joint impossible or restricts some of the movement;
- there is a partial gap that restricts movement, causes pain;
- conservative treatment was unsuccessful.
Preparing for the Surgery
Before the rotator cuff surgery it is necessary to undergo the lab examination, which is essential for administration of anesthesia. It included ECG, fluorography, blood and urine tests. These tests can be done on an outpatient basis to shorten the hospital stay. There also additional examinations may be prescribed for the rotator cuff repair, such as X-ray, ultrasonography and MRI.
Results and Recovery
After the rotator cuff surgery, the arm is immobilized in the abduction position for several weeks using a special splint. This treatment reduces the tension on the tendons and reduces the risk of re-rupture. The duration of such treatment is determined by the surgeon who performed the operation, since only he can assess the condition of the rotator cuff tendons. Usually a splint (orthosis) is applied for 3-6 weeks after the rotator cuff repair.
After that, the rehabilitation treatment begins, the intensity and sequence of which will be selected by the doctor. In general, the postoperative and rehabilitation period can be divided into three periods:
- protection of the rotator cuff tendons. The arm is immobilized so that the gap can heal;
- restoration of the movement range;
- restoration of strength.
Rotator Cuff Success Stories
Until a year ago, those tasks were nearly impossible for the 82-year-old St. Petersburg resident. Suffering from arthritis in his right shoulder and tears in his rotator cuff, Stuart couldn’t raise his right arm over his head. Even small shoulder movements were painful.
Jeanette L. tore her rotator cuff last October when she missed a step and grabbed hold of a railing. Being right-handed, her first thought, was “Thank God, it’s my left arm.” However, she was surprised by how little she could do. “I couldn’t dress or undress myself, button or unbutton my blouse, zip my pants or even brush my hair,” says the 54-year old wife, mother and grandmother, who lives in Orlando. Worst of all, she couldn’t play with her grandchildren.