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Scoping Out Surgery for Torn Rotator Cuff Tendons

The shoulder is now recognized as one of the most common places for injury. Sports activities, work-related events, arthritis, and the wear and tear that comes with age can cause shoulder problems. One particular injury is a torn tendon in the rotator cuff. Tendons connect muscles to bones. By pulling on the tendon, muscles are able to make bones move.

The rotator cuff is made up of four muscles. The tendons of the rotator cuff encircle the shoulder joint the way the cuff of a shirtsleeve circles the wrist. The rotator cuff holds the upper arm bone into the joint socket and turns the arm in and out. When one of the tendons in the rotator cuff is injured, torn, or damaged, pain and loss of motion occur.

Surgery is sometimes required to repair the torn tendon. The surgeon makes an incision into the shoulder to find and repair the torn tendon. A second way to reach the muscle is with an arthroscope, a small TV camera that allows the doctor to look inside the joint without cutting open the shoulder. The exact method used to repair the torn tendon depends on the shape of the tear.

Doctors doing this type of shoulder repair with an arthroscope would like to know: how good are the results? Does it matter how large the tear is or how long ago the muscle was injured? By reviewing 59 cases of arthroscopic rotator cuff repair, one physician was able to report good results. The results were measured by decreased pain and increased shoulder motion, especially the ability to use the arm overhead.

More than half of the people in this study had large or very large tears. No matter the size of the tear, almost everyone (95 percent) reported good to excellent improvement by the end of four months. In fact, even massive tears fared better with the arthroscope compared to past studies using "open" methods of surgery. (Open surgery requires the surgeon to make a large incision through skin and muscle to operate on the torn rotator cuff tendon.)

Arthroscopic repair can be successfully used with rotator cuff tears of all sizes and shapes--even tears from several years ago!

References: S. S. Burkhart, MD, et al. Arthroscopic Rotator Cuff Repair: Analysis of Results by Tear Size and by Repair Technique--Margin Convergence Versus Direct Tendon-To-Bone Repair. In Arthroscopy. November/December 2001. Vol. 17. No. 9. Pp. 905-912.

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