dr.ravigupta008@gmail.com, +91 96461 21592
Monday to Saturday 10AM-04PM
The rotator cuff is constituted by confluence of four muscles and tendons that surround the shoulder joint that ensures that the movement of the ball of the shoulder in the glenoid socket is smooth, powerful and pain free.
A rotator cuff tear causes shoulder pain especially at night and also inability/ discomfort in lifting the arm up. In some cases there is complete loss of movement at the shoulder known as pseudo-paralysis.
The rotator cuff tear can be caused in young persons by an injury mostly a sports injury or fall on the shoulder.
In elderly persons the rotator cuff gets degenerated due to aging making it prone to degenerative tears with minor injuries like jerks to shoulder/ lifting of weights/ minor falls or it can tear even without any injury.
Symptoms of rotator cuff tear include shoulder pain that usually is more at night. Patient may be unable to take hand to hair or back. Patient may feel a weak arm or even rarely a totally powerless arm. All the symptoms may not be present in all the patients.
The rotator cuff tear may be partial or complete tear. The partial tears mainly cause shoulder pain while complete tears can cause shoulder pain and weakness.
Sometimes the rotator cuff tear may be seen more commonly amongst members of the same family because of a little genetic predisposition.
The diagnosis is made by clinical examination and MRI.
The treatment of partial tears may be non operative. But weight bearing physiotherapy exercises and jerky movements have the potential to convert a partial tear to a complete tear.
For complete tears and for partial tears not amenable to non operative treatment, the treatment of choice is arthroscopic rotator cuff repair. It is a key hole surgery. The success rate in young persons with traumatic tears is near to almost 100%. In degenerative treats, the success rate is around 80 %.
The technique of repair involves implantations of tiny bony anchors into the bone of the shoulder joint. The anchors emit high quality suture threads at their tips so the thread is anchored in the bone. Then the bite of the thread is taken through the torn cuff and tied with knot over the anchor.
After the repair, the shoulder is protected in an abduction brace for 6 weeks so that the gravity does not pull the tied suture over the anchors due to traction. But on the very next day of the surgery, the patient is also started with some shoulder exercises usually in the lying down position that eliminates the gravity.
After six weeks of surgery, gentle exercises are started under the supervision of the operating surgeon. Usually by 3-6 months, the patient returns to all the pre injury activities.