The rotator cuff is actually four muscles around the ball of the shoulder joint; these muscles help to rotate and elevate the arm and stabilize the shoulder joint, says the American Association of Orthopaedic Surgeons, or AAOS. When a tear occurs in the rotator cuff, pain, restricted range of motion and weakness can occur. Surgery is typically used if non-surgical treatments are not effective and weakness and loss of motion and function occur.
Open Repairs
In open repair surgery to repair the rotator cuff, a surgeon places an incision above the affected shoulder and detaches the deltoid muscle, according to the AAOS. This allows the surgeon to access the rotator cuff and examine the tear. During this type of surgery, bone spurs are often removed from the underside of the collarbone, as well. A mini-open repair is a similar surgical option; in this procedure, a smaller incision than a traditional open repair is made and arthroscopy is used to see the damage inside the joint and treat any associated damage, says the AAOS. After this is completed, the surgeon repairs the rotator cuff through the mini-open incision that was made. Mini-repair has been shown to yield similar results as open repairs, according to the AAOS.
Arthroscopic Repair
Arthroscopy involves inserting a thin device that has a lens and lights on the end through small incisions in the joint. The lens on the end of the device relays pictures of the joint onto a screen, allowing the surgeon to see the affected area while being minimally invasive. Arthroscopic repair of the rotator cuff allows the surgeon to examine and repair the injured muscles through multiple small incisions. Dr. James Dreese, an orthopaedic surgeon at the University of Maryland Medical Center, describes the advantages of this type of surgery as including less disruption of the normal structure of the shoulder musculature, smaller incisions and potentially less pain afterwards. In arthroscopy, cutting through and splitting muscle layers is not performed, causing less pain after surgery, but recovery time is not changed. This is because tendons still take the same amount of time to reattach to the bone, according to the University of Maryland Medical Center.
Partial or Full Shoulder Replacement
Patients with long-term rotator cuff tears may eventually develop a kind of arthritis called rotator cuff arthropathy, according to the Mayo Clinic. Treatment for this involves a hemiarthoplasty, commonly known as a partial shoulder replacement. A new device that has recently received Food and Drug Administration approval allows a reverse ball-and-socket shoulder replacement that enables a patient with rotator cuff injuries to raise their arms over their head again, says the Mayo Clinic.
