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Orthopaedic Surgery

Arthroscopic rotator-cuff repair avoids cutting the deltoid muscle

10/01/2008

An innovative arthroscopic procedure offers a minimally invasive approach to treating rotator-cuff tears. The operation is performed through three or four puncture wounds using a camera and specialized arthroscopic instruments. Traditional rotator-cuff repair surgery involves a 3-to-6 cm incision in the deltoid muscle.

The rotator cuff, a series of four muscles, helps shoulder elevation and strength. Trauma or the general wear and tear of aging can tear the rotator-cuff muscle away from the humerus bone.

Candidates for the procedure

Symptoms of a rotator-cuff tear include shoulder pain during activity, night pain, weakness and difficulty with overhead activities. Conservative treatment with physical therapy, anti-inflammatory medications and steroid injections can help improve the symptoms. If these modalities fail to sufficiently alleviate symptoms, arthroscopic rotator-cuff repair may be recommended.

X-rays and magnetic resonance imaging (MRI) are used to confirm the diagnosis and document the location and size of the tear. Advances in tools and techniques enable surgeons to arthroscopically repair most forms of rotatorcuff tears formerly performed through a conventional incision.

How it works

Using three to four incisions smaller than 1 cm each, the surgeon first inserts a camera to inspect the tear. The humerus is then prepared with an arthroscopic burr to create a surface on which the rotator cuff can heal. Next, a series of suture anchors (small screws with sutures attached) are placed in the bone. The sutures are then used to securely fasten the rotator cuff to the humerus. After the tear is repaired, bone spurs — present in most rotator-cuff patients — are removed to normalize the space for the rotator cuff. The procedure is performed on an outpatient basis.

Advantages of arthroscopic rotator-cuff repair

Arthroscopic rotator-cuff repair offers several advantages over conventional surgery, including:

  • smaller incisions
  • less trauma to the deltoid muscle
  • less post-operative pain
  • shorter recovery time
  • improved function

Experience counts

Arthroscopic rotator-cuff repair is a technically demanding procedure and is best performed by surgeons with extensive experience. UCLA physicians have the advanced training and high patient volume that are crucial to achieving the best-possible clinical outcomes.

Contact information

Department of Orthopaedic Surgery UCLA Medical Center, Santa Monica (310) 319-1234

Program physicians

Gerald A. M. Finerman, M.D.
Professor and Chairman of Orthopaedic Surgery
Head Team Physician, UCLA Athletic Department
Director, Total Joint Arthroplasty

Seth C. Gamradt, M.D.
Assistant Professor of Orthopaedic Surgery
Sports Medicine and Arthroscopic Surgery

Sharon L. Hame, M.D.
Assistant Professor of Orthopaedic Surgery
Sports Medicine and Arthroscopic Surgery

David R. McAllister, M.D.
Associate Professor of Orthopaedic Surgery
Chief, Sports Medicine Program
Sports Medicine and Arthroscopic Surgery

Ali R. Motamedi, M.D.
Assistant Professor of Orthopaedic Surgery
Director, UCLA Orthopaedic Hospital Associates
Sports Medicine and Arthroscopic Surgery





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