Irreparable Rotator Cuff Tear
The rotator cuff is a group of four muscles whose tendons cover the shoulder joint and support its movement. Tears in the rotator cuff can cause pain and disability and are usually treated with conservative or surgical methods. However, some tears of the rotator cuff do not heal with these methods and are considered irreparable.
When you visit the clinic with persistent shoulder pain, your doctor will review your history, perform a physical examination and order CT or MRI scans to confirm the diagnosis.
Signs that may indicate an irreparable rotator cuff tear include:
- Prolonged duration of symptoms
- Weakness while rotating the arm outwards
- Narrowing of the space between the bony prominence of the scapula (shoulder blade) and the humerus (upper arm bone)
- Infiltration of fatty tissue within the rotator cuff musculature
- Retraction of the tendon from its attachment.
Treatment options for irreparable rotator cuff tears include:
- Non-operative treatment: Physical therapy to improve the strength and range of motion of the muscles that surround the shoulder and steroid injections to bring down swelling and pain.
- Arthroscopic procedures: Debridement or removal of damaged tissue from the joint, releasing the damaged or inflamed biceps tendon from its attachment at the shoulder, partial repair of tissues where possible, suprascapular nerve release if the rotator cuff tear is pulling on the nerve causing painful symptoms.
- Muscle transfer: Transfer of muscle from the back (latissimus dorsi) or chest (pectoralis major) to repair the torn rotator cuff.
- Hemiarthroplasty: Replacement of the humeral head with an artificial prosthesis. It is indicated in cases of arthritis of the shoulder when the arm is still able to be raised.
- Reverse total shoulder arthroplasty: Replacement of the shoulder ball and socket joint with artificial prostheses but interchanging their positions so that the ball is attached to the shoulder blade and the socket to the humerus. This technique is used in severe cases where the arm is almost paralyzed due to pain and cannot be lifted.
Correlating the correct treatment option with your condition is critical in ensuring the best possible surgical outcome.