A rotator cuff tear can be repaired either via an “open” or an “arthroscopic” approach. I perform all of my rotator cuff repairs arthroscopically. Nationally, the trend is an arthroscopic approach, but 20-25% of repairs nationally are still performed through an open approach.
While the outcomes of rotator cuff repair are very good, recovery from the procedure can be a substantial burden and require significant planning whether it is arranging around important events or work. Because of this, patients often ask “How soon do I need to have this done?” The answer to this question is about the influence of time on outcome.
Atrophy is an important consideration in rotator cuff tears. Atrophy is when a muscle shrinks in size well accepted that greater atrophy leads to a poorer chance of healing following rotator cuff repair. In general, the greater the atrophy, the lower the chance of obtaining healing.
Superior capsule reconstruction (SCR) is a procedure that is used in the treatment of irreparable rotator cuff tears. The procedure was first described in 2013 by Dr. Teruhisa Mihata from Japan. Patch grafting has a long history of being used to "bridge gaps" in irreparable rotator cuff tears. Mihata’s innovation was attaching the graft to the glenoid or socket site of the joint as opposed to sewing the graft into soft tissue.
With changes in health care physicians are increasingly being scrutinized for the care they administer including rotator cuff repair. More and more we are required to ask ourselves whether a procedure or medicine is cost-effective, that is does it produce a result medically and does it come at a reasonable cost.
An emerging topic in the shoulder world is screening for rotator cuff tears. One question is if the opposite shoulder should also be screened for a rotator cuff tear. That is, if someone has a rotator cuff tear in one shoulder, should the other shoulder be evaluated with an MRI or ultrasound to determine if there is a tear in the opposite shoulder?
There are several types of acromioclavicular (AC) separations. Low grade injuries (Type I and II) involve limited injury to the AC joint only and should be managed conservatively. In contrast, high grade injuries (Type IV, V, and VI) involve injury to the AC joint, coracoclavicular (CC) ligaments, and overlying fascia and should thus be managed surgically.
Shoulder arthroscopy has been a major advancement in the treatment of shoulder conditions. Through the use a camera and small stab incisions, conditions in the shoulder can be clearly viewed and treated in a minimally invasive fashion.
Reverse shoulder replacement can have a substantial impact on your shoulder function and quality of life. The procedure was developed in France and then approved for use in the United States in 2004.