Rotator cuff repair

Surgery may be used to treat a rotator cuff disorder if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.

The rotator cuff is a group of four tendons and the related muscles that stabilize the shoulder joint and allow you to raise and rotate your arm. The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). These bones are held together by muscles, tendons, ligaments, and the joint capsule. The rotator cuff helps keep the ball of the arm bone seated into the socket of the shoulder blade.

Surgery to repair a torn rotator cuff tendon usually involves:

• Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement).
• Making more room for the rotator cuff tendon so it is not pinched or irritated. If necessary, this includes shaving bone or removing bone spurs from the point of the shoulder blade (subacromial smoothing).
• Sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).

In open shoulder surgery, a surgeon makes an incision [2 in (5 cm) to 3 in (7.6 cm)] in the shoulder to open it and view the shoulder directly while repairing it. A smaller incision can be done with a mini-open procedure that allows the surgeon to reach the affected tendon by splitting the deltoid muscle. This method may reduce your chances of problems from a deltoid injury.

Open-shoulder surgery often requires a short stay in the hospital.

General anesthesia or a nerve block may be used for these types of surgical repair.

Rotator cuff tears can sometimes be repaired with arthroscopic surgery.

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