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Vital Signs
Shoulder Repair with Minimal Cutting
Surgeons can now repair a torn rotator cuff without cutting through the deltoid muscle that surrounds the shoulder, facilitating quicker recovery with less pain and fewer complications.
The rotator cuff is the group of four muscles and tendons that stabilize and help move the shoulder. Damage to the cuff — ranging from inflammation to severe pain caused by a partial or complete tear of the muscle or tendon — can be caused by traumatic injury such as a fall, by repetitive overhead activities such as painting or pitching a ball, or by the normal wear and tear of aging, explains Robert Pedowitz, M.D., Ph.D., chair of orthopaedic surgery at UCLA and a specialist in sports medicine and arthroscopic surgical repair. Symptoms of a rotator cuff injury include shoulder pain during activity, night pain, weakness and difficulty with overhead activities.
The outpatient arthroscopic procedure “is just as effective and durable” as the traditional open surgery, explains UCLA orthopaedic surgeon Seth C. Gamradt, M.D.
A camera and instruments are inserted through three or four small incisions to make the repair, the surgeons explain. Suture anchors — small screws with sutures attached — are placed in the bone to reattach muscle and tendon. After the tear is repaired, bone spurs (excess bone that can grow along the edges of bones and can impinge on the tendons and cause pain) are removed.
Patients can expect to wear a sling for about six weeks as the repair heals and to undergo physical therapy to regain the fullest use of their shoulder.
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