Partial Rotator Cuff Tear
Rotator cuff disease is a common disorder and can result in significant pain and dysfunction in the shoulder (See “Rotator Cuff Disease”). The rotator cuff is a blending of 4 tendons together, which envelop or ‘cuff’ the ball of the shoulder joint and assist in stabilizing and rotating the shoulder. Rotator cuff tears may occur following a traumatic injury to the shoulder, often from a fall onto the arm, elbow or outstretched hand. Alternatively, tears may evolve slowly from chronic demand and / or abrasion on the roof of the shoulder (acromion). Rotator cuff disease often begins as a partial-thickness tear, either on the deep surface (articular side), or the outer surface (bursal side). Conservative treatment including ice, non-steroidal anti-inflammatories, physical therapy for motion and strengthening exercises along with occasional cortisone injections is often effective in minimizing symptoms related to partial-thickness cuff tears. When pain persists despite thorough conservative care, arthroscopic surgery may be indicated. A small shaver 1/5 of an inch wide is effective in cleaning up or debriding ragged cuff margins when the tear is less than 1/3 the thickness of the normal cuff. Debridement can be effective for tears on both surfaces, but the results tend to deteriorate over time. When the defect is up to 2/3 the normal thickness, specialized techniques can be performed with small instruments to prepare and repair the torn tendon back to the normal bony attachment. Small anchors facilitate attaching the rotator cuff back to bone. When the tear is > 2/3 of the tendon, consideration is given for detaching the small remaining amount of intact rotator cuff to enable the full thickness of the tendon to be securely reattached to bone in its normal position. Physical therapy as well as home exercises contribute to regaining shoulder motion and strength. Complete healing may require as long as 7 – 8 months.