What Is It?

Arthroscopic Shoulder Rotator Cuff Repair is a minimally invasive surgical procedure meant to repair the damaged tendinous portions of prominent muscles holding the humeral head to the socket in the shoulder.

Your body’s rotator cuff is a collection of four muscles and their corresponding tendons in the shoulder which connect the upper arm and shoulder blade. Appropriately referred to as the rotator cuff, this collection of tissue forms a stable ‘cuff’ around the humeral head and helps the shoulder rotate freely.

Why Is It Done?

There are several ways in which a rotator cuff can become injured, and a seemingly endless amount of potential causes for each injury. Repetitive overhead activity, heavy lifting for an elongated period of time, and bone spurs near the shoulder can all lead to tendon damage. Blue-collar occupations and sports participation that involve strenuous and repetitive arm motions can significantly wear-down and damage this tissue over time. Through any of these ways, and many more, your rotator cuff can develop tendinitis, subacromial bursitis, can become pinched or irritated by surrounding bones, and can even tear.

Typically, rotator cuff injuries lead to pain in the front of the shoulder which radiates down the side of your upper arm. Pain is often described as a dull ache coming from deep within the shoulder. Patients have reported symptoms of disturbed sleep, arm weakness, and difficulty performing routine activities that involve reaching your arm above your head or behind your back.

Many damaged or torn rotator cuff tendons can be symptomatically treated non-surgically through physical therapy and anti-inflammatory medications or injections, but almost all tears will not heal entirely on their own. With repetitive use, rotator cuff injuries can become worse and tears can expand over time. If persistent pain or shoulder weakness continues to prove bothersome and debilitating, preventing normal activities of daily living, surgical procedures are recommended.

How Is It Done?

Surgery to repair a torn or damaged rotator cuff is primarily conducted arthroscopically. Arthroscopic surgery is a minimally invasive procedure in which a high-definition, fiber optic camera is inserted through small incisions to evaluate the glenohumeral joint (shoulder joint), and supporting soft tissues, including the four rotator cuff muscles, labrum, biceps tendon, articular surfaces, ligaments, and bone. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through tubes called cannulas.

Arthroscopic surgery to repair a damaged rotator cuff commonly involves: removing debris that can inhibit movement near the joint, shaving or removing bone spurs which force tendons to become pinched, or sewing the torn edges of tendons back together and reattaching the tendon to the bone.

Generally, as arthroscopic surgery is performed in the least invasive manner possible, recovery is quicker and less painful. Most patients return home on the same day in which they have the surgery, and will have their arm protected in a sling and an abduction pillow for a set period of time. Recovery from rotator cuff surgery is very dependent on rehabilitation efforts. A lack of movement for extended periods of time can cause the repaired tendon to thicken and painfully restrict joint movement. Physical therapy programs and frequent exercise will help encourage movement, build strength and ultimately ensure that the joint remains healthy and active.