Repairing Rotator Cuffs with Surgery

Sometimes patients continue to experience shoulder pain despite medication, physical therapy, prescribed exercises and rest. When this happens, there are a number of surgical procedures available to reduce pain in the rotator cuff and potentially reconstruct your shoulder.

Why It’s Performed - The rotator cuff explained

The rotator cuff is made up of four muscles that run from the shoulder blade to the ball of the upper arm bone that are attached to the humerus ball by tendons. When working properly, these muscles keep the humerus ball centered in the socket while the larger, adjacent muscles move the arm.

If rotator cuff muscles aren’t functioning normally, the patient experiences pain that can lead to disability. Pain is typically experienced just below the shoulder, over the outside of the upper arm. Shoulder pain can be caused by many problems. It is possible that collagen, tissues that make up rotator cuff muscles and tendons, have weakened because of age or normal wear and tear. Overusing your shoulder can cause muscles and tendons to deteriorate more quickly and lead to tears. Sometimes falling on an outstretched arm can tear or injure the rotator cuff muscle and tendon. Another possibility is the presence of arthritic bone spurs or calcium deposits on the overlaying bones that pinch the tendons and irritate the muscles.

How It’s Performed - Options for surgical repair

Arthroscopy is a surgical procedure completed through very small, pencil-thin incisions. Surgeons use this method to repair torn or worn out tendons and bone spurs in the shoulder area, as well as handle any abnormal changes to the tissue covering and lubricating the top of the rotator cuff, called the bursa.

Mini-open or open repair is a surgical procedure completed either through a number of small incisions or one incision that spans the shoulder. Surgeons use this method to reach and repair a large, complex rotator cuff tear by splitting or detaching the deltoid muscle that is over the shoulder.

Reverse shoulder arthroplasty is a more complicated surgical procedure that surgeons use when the rotator cuff has wearing or tearing beyond repair. The surgeon replaces the shoulder ball with a socket and the shoulder socket with a ball, which changes the joint mechanics of the shoulder so the arm can move freely despite the absence of a properly functioning rotator cuff. Most patients experience relief from pain and improved shoulder function after reverse shoulder arthroplasty.  

Leading specialists

Dr. Dan Hot

Head of the Hand Microsurgery Department

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