Arthroscopic or open rotator cuff repair


arthroscopic rotator cuff repair, rotatore cuff suture, reconstruction
"The cuff" covers the bony shoulder joint in front, above and at the back. The rotator cuff consist of four muscles, which center the humeral head into the glenoid. Contracting and stretching they are moving the shoulder and the arm. Those four muscles are called: supraspinatus, infraspinatus, subscapularis and teres minor muscle.
Due to trauma or degernation the tendons of these muscles can rupture. The older the patient the more those cuff defects are caused by degeneration.


When to operate a rotator cuff tear ?
Most of the cuff defects can be treated without an operation in an non-operative attempt, during the first weeks. The younger the patient and if conservative treatment fails, an operation will be performed. Within the last time it was scientifically and evidence based proofed, that an operation of small and medium size rotator cuffs tears is superior to physiotherapy.


Techniques of a rotator cuff repair:
Most of the cuff repairs are done arthroscopically today. The operativ cuff repair can alternatively be done by an open operation or with a mini open repair, which are used far less. A lot of factors like age, tissue quality, size and position of the defect and the possibilities to mobilize it are influencing the results of a rotator cuff reconstruction.


Why to do a rotator cuff repair:
It´s the aim of an operation to get rid of the pain - especially also the pain at night, to improve strength and to get a better mobility of the shoulder and the arm.


How to operate a rotator cuff repair:
Starting such an operation the surgeon makes a survey of the shoulder joint, the defect and cocomitant traumatic or degenerative structures. Depending on the individual situation he will decide, which kind of repair he will use. Performing an arthroscopic repair a few skin incision, about 0.5 to 1 cm - each, are made at the front, back and lateral side or on top of the shoulder. Using these portals cannulas and working instruments, like shavers, graspers, suture devices, anchors and so on, are used. The whole operation can be monitored an a TV / PC screen, all the time.


Rehabilitation of a rotator cuff repair:
After a cuff repair the operated arm is placed in a splint or on an abduction pillow. Normally, passive motions are allowed at once and performed for 3 to 4 weeks with the assistance of the physiotherapist. Hospital stay will last 2 - 4 days. Active motion can start after 3 to 6 weeks, depending on the individual situation of the patient. The rehabilitation period will last for about 3 to 4 month, over all. Depending on the profession the patient can return to work after 2 weeks ( office work ) to 4 month ( heavy physical work ). Sports with the arm and shoulder is allowed after 3 month.


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