Rotator Cuff Procedures Denver
What is the Treatment for Rotator Cuff Tears?
The conservative treatments for rotator cuff tears include: physical therapy, avoiding overhead or other aggravating activities, and anti-inflammatory medications (NSAIDS). Most partial rotator cuff tears respond well to physical therapy and activity modification so surgery is never needed. If conservative treatments fail to improve the pain and function of the shoulder, surgical intervention may be recommended.
With advances in technology over the last decade, most rotator cuff tears can be repaired arthroscopically, which means that a video camera and small specialized tools are inserted through a series of small incisions to complete the repair. The affected rotator cuff tendons are reattached to their usual insertions on the head of the humerus, which restores the rotator cuff muscles’ functions and reduces the pain related to the tendon tears.
In order to reattach the tendons to the bone, small holes are drilled in the head of the humerus and tiny anchors with sutures attached to them are embedded in the holes in the bone. The surgeon loops the suture through the torn end of the tendon and pulls the tendon back down to the bone. A series of specialized knots are tied in the suture to hold the tendon in place next to the bone. This procedure is repeated with as many anchors as needed to secure the tendons to the bone to prevent the tendons from retracting before the body can scar over the tendon attachments on the humeral head. The sutures are only a temporary fixation and the scar that develops during the healing process becomes the permanent fixation for the tendon to the bone. Patients must wear a sling and avoid moving their arm at the shoulder joint for four to six weeks to protect the repair and allow the body time to heal before the tendons are stressed; otherwise, the repair may fail.
The surgery is followed by a course of formal physical therapy that is tailored to each patient’s specific needs and therapy is usually needed for three to six months after surgery to regain strength and range of motion. Typically, the procedure is done on an outpatient basis and most patients are able to return to sedentary work and modified daily activities within a few weeks. Patients that have jobs involving manual labor will likely be out of work or on light duty until three months post-operatively or longer.
What is an Open Rotator Cuff Repair?
There are certain rotator cuff tears that cannot be successfully repaired through the arthroscope so a larger incision is made to entirely expose the rotator cuff and the humeral head. The rotator cuff is reattached to the head of the humerus in the same way as described above by using anchors and suture. Immobilization, work restrictions, and physical therapy courses are the same whether the repair is done open or arthroscopically.
What is the Treatment for Rotator Cuff Impingement?
The conservative treatments for shoulder impingement and bursitis include: rest, avoiding overhead or other aggravating activities, anti-inflammatory medications (NSAIDS), physical therapy, and cortisone injections. If conservative treatments fail to improve the pain and function of the shoulder, surgical intervention may be recommended. Most surgical procedures used to treat shoulder impingement and bursitis can be done arthroscopically through a series of small incisions. The most common procedure is a subacromial decompression but occasionally a rotator cuff repair is needed due to excessive damage to the tendons.