Rotator Cuff Anatomy & Function
The rotator cuff is a cluster of four muscles that are assembled to form a tough cuff (tendon) that is attached on the humerus (upper arm bone). The four muscles that assemble to form the rotator cuff are the teres minor, subscapularis, infraspinatus, and supraspinatus. The rotator cuff has a very significant purpose: holding the humerus in place to permit rotation and raising of the arm. It is particularly important in activities above the head.
Tears of the rotator cuff are normally seen among adults. Warning signs of the tears consist of weakness, shoulder pain, and may lead to major disability depending the nature and how extensive the tear is. Common symptoms of a tear of the rotator cuff include feebleness and pain while raising the arm, straining to hold the arm overhead, pain and discomfort while taking down the arm, and sounds of cracking in the course of arm movement. Often patients with a tear of the rotator cuff have complaints of trouble of sleeping on the position of the affected shoulder, and aches when in attempt of particular motions, for instance reaching for a the safety belt of a vehicle or combing of one’s hair.
There are a wide variety of reasons that can lead to tears of the rotator cuff. Ordinarily, tears of the rotator cuff are witnessed in people of over 40 years of age and have a tendency of being caused by repeated injury as well as wear and tear. Tears of the rotator cuff are mostly experienced by those who take part in repetitive motions over the head from either their occupation or sport they actively participate in. Even though the cuff tear could be a result of overuse of the tendon, it may also be as a result of a single traumatic occurrence such as in the process of lifting a heavy object or a fall.
If fitting, Dr. Samimi constantly has preference to begin with old-fashioned treatments for minor or partial thickness tears of the rotator cuff. Some of the conventional treatments include anti-inflammatory pain prescriptions, physical rehabilitation and strengthening workouts, steroid injections and activity modification.
The moment conventional treatments fail to provide liberation or rather the solution of a more critical or traumatic tears of the rotator cuff, surgical repair is usually recommended. Surgical restoration of a torn rotator cuff will assist in pain relief, give allowance for better strength, recover the range of motion and inhibit further cuff tearing.
With respect to the extent of the damage, the nature and type of the cuff tear, the rotator cuff surgical process may be differ at times. A fractional tear may simply need a debridement (smoothening) of the cuff portion that is torn. A complete or full thickness tear, needs the bringing back together and attaching of the edges of the tendon back to the bone. Among the specialties of Dr. Samimi is the treatment of complicated shoulder problems which may need arthroscopic surgery, as well as rotator cuff repair.
What happens during the Rotator Cuff Repair procedure?
The shoulder arthroscopy surgical procedure is used in visualization, diagnosis, and treatment of complications inside a shoulder joint. It involves creation of a minute incision in the skin’s surface then injecting a pencil-sized arthroscope in the injured joint. The arthroscope’s miniature camera and associated instrumentation gives the allowance of visibility by Dr. Samimi inside the affected joint in an enlarged and well-lit manner. This allows accurate diagnosis of the degree and pattern of the tear of the rotator cuff and successful repair.
After evaluation of the shoulder joint, the orthopedic surgeon positions the camera above the tendons of the rotator cuff, known as the subacromial space. The area over head the rotator cuff can then be checked, cleaned out in case of damaged or inflamed tissue, and the bone spur or rather the acromion spur which could be resulting in the impingement of tendons can be removed.
Later, the tendon is either stitched together or attached back to its original insertion on the bone with use of suture anchors. Suture anchors can be made of plastic, metal, or a material that can organically dissolve over time, and won’t need removal.
After the surgery, the incisions are also closed with sutures and dressed with a bandage. Patients normally go back home the same day in a sling and a course of physical therapy follows. Two days after surgery the bandage can be removed. The tiny incisions are simply shielded by a band-aid.
Dr. Samimi takes snap shots of the surgical procedure via the video monitor to illustrate to you the findings and the proceedings of the surgery. He feels it is significant for you to comprehend the nature of the situation and precisely what was done in order to fix it.
This surgical procedure is almost always executed as outpatient surgery and it has a selection of benefits like a lowered risk, reduced complications, minimal postoperative pain, accelerated recovery time, and reduced scarring. Using this slightly invasive practice we accomplish rotator cuff repairs with exceptional results.
For detailed facts and figures about this condition and treatment procedures such as Rotator Cuff Repair please visit: AAOS Online Service Fact Sheet – Rotator Cuff Tears