The Approach to Rotator Cuff Tear
The rotator cuff comprises a group of 4 muscles and their tendons that surround (“form a cuff around”) the shoulder joint. The rotator cuff is responsible for centering the humeral head (the ball at the top of the humerus bone) in the glenoid or shoulder socket. Rotator cuff injuries are common, and their incidence increases with age. Trauma or jobs that require repetitive overhead motion often result in the early onset of rotator cuff injuries.
Rotator cuff injuries, including strains, tendinitis, partial and full-thickness tears comprise the most common shoulder condition in patients over age 30. Selecting the proper treatment for a rotator cuff tear requires careful integration of history and physical examination findings as well as the results of radiographs and advanced studies, such as MRI.
Most rotator cuff strains and tendinitis respond to conservative treatment. However, there is compelling evidence that supports early repair of most full-thickness rotator cuff tears in younger, more active individuals because these tears do not heal on their own and generally enlarge over time. Care must be taken to exclude, pre-operatively, those tears that may not be repairable or worth repairing such as tears arising in tendons that are atrophic or otherwise deficient and tears associated with muscles that have atrophied irreversibly. Most rotator cuff tears, including larger more retracted tears, can be repaired using arthroscopic or arthroscopic-assisted techniques. Our surgeons specialize in arthroscopic rotator cuff repairs. Outcomes following all-arthroscopic repair have been exceptional and complications such as stiffness or re-tear are rare.
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