Rotator Cuff Repair

Rotator Cuff is a group of 4 small muscles which hug the shoulder joint closely and help to fine tune the shoulder movements. The rotator cuff tear can be due to acute injury or due to repetitive strain. A complete tear needs an arthroscopic (keyhole) surgery to repair.

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Diagnosis

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Physical examination reveals pain and weakness in certain angle of movement (open can and closed can tests).

X-ray. X-ray is performed and is useful to assess the type of the acromion (outer projecting edge of the shoulder blade) bone and for signs of arthritis. However, rotator cuff tear is not visible on the X-ray.

Ultrasound Scan. Ultrasound scan of shoulder has got a role in assessing the state of the rotator cuff muscle. Ultrasound has got certain limitations as it is poor at differentiating between the partial tear and a complete tear of the muscle tendon.

MRI Scan. MRI Scan is the gold standard investigation to identify the type and extent of the Rotator cuff tear. It also helps in understanding the condition of the muscle. In addition, it helps to assess the condition of the muscle tendons, rest of the labrum (lip of the socket) and the quality of the biceps tendon. 

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Treatment

 

Partial Tear of Rotator Cuff Management

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Selected partial tears can be managed with PRP Injection. Complete tears will not respond to this mode of treatment. 

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Rotator Cuff repair Surgery

 

Rotator Cuff repair surgery is a day care surgery. Through arthroscopy (Keyhole), the shoulder joint is assessed and the joint structures are evaluated. The extent of the tear and the quality of the muscle are assessed. The muscle is mobilized to the point of its attachment and then fixed to the bone using fiberwire threads and the suture anchors.

The suture anchors are made up of different materials

•           PEEK (high grade polymer)

•           Biocomposite (becomes bone)

•           Metal (titanium)

 

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Rotator Cuff Repair Rehabilitation

 

Post-surgery, you can expect to be in a broad arm sling supporting your arm. Rehabilitation in the form of gentle passive mobilisation is started early usually by 2nd week. Active ROM exercises are started usually by 3th week post-surgery. Strengthening exercises typically start post 6 to 8 weeks. To achieve full functionality including lifting objects, you can expect it to take around 4 to 6 months.

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