Rotator Cuff Surgery

The rotator cuff allows for movement of the shoulder and provides stability. It is made up of 4 muscles and their tendons that attach the humerus to the scapula. Tears of the rotator cuff are very common and can occur from degenerative changes (wear and tear) or from an acute injury.

Orthopaedic surgeons can treat a rotator cuff tear surgically through several different approaches.

The open approach was the original surgical technique used to repair a torn rotator cuff. With the development of newer, less invasive techniques, the open approach is used less frequently.

The second option is a mini-open approach. The surgeon will normally evaluate the shoulder arthroscopically initially to clean up or debride some of the soft tissue in preparation of repairing the rotator cuff. Bone spurs can be removed arthroscopically at the same time. A small incision (3 to 5cm) is then made over the shoulder and various types of anchors are used to reattach the torn tendon(s).

The third approach, which has become the most popular method of repairing a rotator cuff, is arthroscopic repair. Again, the surgeon will use the arthroscope to visualize the torn rotator cuff tendons, debride soft tissue, remove any bone spurring present and then place specially designed anchors into the shoulder. These anchors are placed through tiny incisions that allow the surgeon to set the torn tendons back together. Anchors used for rotator cuff repair are made of bone, metal, or plastic. In some cases, they eventually are absorbed by the body once healing takes place.

In some cases graft extenders or scaffold must be used to repair a badly torn rotator cuff. In other cases, the rotator cuff may only need to be debrided as in a partial tear.

Each of these options have advantages and disadvantages. Not every patient is a candidate for the less invasive, arthroscopic approach. Newer materials including tissue grafts and injections with growth factors have been developed and continue to advance the treatment for this condition.

As with any surgical procedure, there are risks to having a rotator cuff repair including infection, nerve and blood vessel injuries, bleeding and blood clots. There are also specific risks associated with anesthesia.