Rotator Cuff Tear

Anatomy

The shoulder is a ball and socket joint in the upper extremity. The glenoid (the socket) and the humeral head (ball) form the gleno-humeral joint. This joint is enclosed in a capsule. Surrounding the shoulder are the tendons of four muscles that are responsible for the initiation and modulation of shoulder movement – the rotator cuff.

Causes

As we get older, these important but small tendons can undergo degeneration, like a pair of well-worn jeans, and tear. These are known as degenerative rotator cuff tears and are present in about a third of people over 65 years of age. The tears do not necessarily cause pain. Sometimes, however, these tears are caused by trauma such as a fall onto the shoulder or the lifting of a heavy weight.

Symptoms

These acute rotator cuff tendon tears cause pain, particularly at night, weakness and difficulty in moving the shoulder. The surgeon will take a detailed and examine you to determine whether you have a rotator cuff tear. He may employ the use of an ultrasound scan or an MRI to help confirm the diagnosis.

Treatment

Once the diagnosis has been made, treatment involves recruiting the remaining intact fibres of the rotator cuff and the surrounding larger muscles to improve shoulder function with physiotherapy. This will be painful, particularly for the first month or so and you will require painkillers. If the symptoms improve and there is no functional impairment then there is no need for further intervention. If the symptoms do not improve, then you may require an injection for pain relief prior to continuing the physiotherapy. Your surgeon will normally only give you up to 2 injections. Further failure to control symptoms may necessitate discussion about surgery to repair the torn rotator cuff, which can be done using open or keyhole surgery.

Knotless Rotator Cuff Repair with Arthrex® SpeedFix™

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