Rotator Cuff Tears: Shoulder Surgical Treatment Options

Repair of a torn rotator cuff by surgical methods usually includes reattachment of the tendon to the head of the humerus, which is the upper arm bone between the shoulder and elbow. If the thickest portion of the tendon is completely torn, it may need to be stitched together. In the case of a partial tear, a debridement, which is a trimming or smoothing procedure, may be adequate.

When Rotator Cuff Surgery is Recommended

If the pain from a torn rotator cuff does not respond to nonsurgical methods, surgery may be recommended. Surgery may also be suggested if you use your arms overhead for sports or work, are very active, have a particularly large tear (one inch or more in length), experience weakness or loss of shoulder function, or the tear was the result of an acute injury.

Surgical Repair Options

Improvements in surgical techniques to repair the rotator cuff have introduced additional options, including less invasive procedures. When recommending a type of repair, your surgeon will consider factors such as your anatomy, the size of your tear, and the quality of the bone and tendon. Each surgical option has some advantages and disadvantages, but the final goal is healing of the tendon.

If you have additional shoulder problems, such as bone spurs, osteoarthritis, or other soft tissue tears, your surgeon may choose to correct these problems during the same operation. Many surgical repairs are performed as outpatient procedures so that you do not need to stay in the hospital overnight.

Rotator cuff repair is usually performed using one of three techniques: traditional open repair, arthroscopic repair, and mini-open repair. These methods can all improve strength, relieve pain, and provide overall patient satisfaction.

Open Repair

If your rotator cuff tear is large or complex, or if it requires reconstruction such as a tendon transfer, repair may require an incision that is a few inches in length. Your surgeon will make this incision over the shoulder and detach the shoulder muscle to view and access the torn tendon. If there are bone spurs on the underside of the acromion (a bony process on the shoulder blade), the surgeon will also remove these in a procedure called an acromioplasty.

While open repair was the first technique developed to repair torn rotator cuffs, surgeons have gained experience and new technology has been developed, creating less-invasive procedures.

Arthroscopic Repair

Arthroscopy involves insertion of a small camera, called an arthroscope, into your shoulder joint. The surgeon uses the images from this camera, which are displayed on a television monitor, to guide the repair.

Because the arthroscope is thin and special miniature surgical instruments are used, only tiny incisions are needed compared to the larger incisions required for open surgery.

Arthroscopic repair is usually an outpatient procedure and is the least-invasive method to repair a torn rotator cuff.

Mini-Open Repair

Mini-open repair uses a combination of arthroscopy and open surgery through a small incision, usually one to two inches in length. This procedure uses newer instruments and technology.

This technique begins with arthroscopy to address damage to other joint structures, such as removing bone spurs. This avoids the need to detach the deltoid muscle. After the arthroscopy, your surgeon will repair the torn rotator cuff through the mini-open incision, viewing the joint directly rather than on the monitor.

No matter which type of surgery is performed, our surgeons at YourOrthoSolution are always keeping you, the patient, in mind and looking for the least-invasive and best way to repair your injury.

All of our doctors and staff at YourOrthoSolution are dedicated to ensuring that you not only receive the best orthopedic care in the area but also have an exceptional experience each time you visit our locations. Our dedicated staff will handle all insurance processes for you. You can expect to be in a friendly atmosphere and receive top orthopedic treatment to help you return to your usual activities as quickly as possible.