Evolution of Technology

Arthroscopic Repair

Repairing rotator cuff tears utilizes a type of suture made of threaded materials as well as anchors. Advances have led to the development of a suture material made of multi-stranded, long chain ultra-high molecular weight polyethylene core with a braided jacket of polyester. The quantity and pattern in which these sutures are used vary depending on surgeon preference and the characteristic/size of the tear. Once these sutures are passed through the tendon, the tendon must then be re-attached to its original location on the bone. This is done with suture anchors and can be made of metal or a biodegradable material.

Evolution of Procedure

Rotator Cuff Repair

Historically, repair of the rotator cuff was done through a large open incision in the shoulder to visualize the torn tendon, which was then repaired and re-attached to the bone. Overtime, advances in surgical technique allowed surgeons to repair the tendon through a much smaller incision, called the mini-open repair. Further advances have led to the ability to repair the rotator cuff arthroscopically with a small camera and specialized instruments placed into the shoulder through 3 or 4 small incisions. Today, rotator cuff repairs are performed either through the mini-open approach or most commonly, arthroscopically. The surgeon first removes any bones spurs and inflamed tissue, which creates space for the repaired rotator cuff tendon. Then, anchors with suture are used to reattach it back to the bone.

Evolution of Diagnosis

Rotator Cuff Tear

The rotator cuff consists of four muscles around the shoulder that help raise and rotate the arm. The most commonly injured of these muscles is the supraspinatus and occurs in the tendon where the muscle attaches to the humerus upper arm bone (humerus). Rotator cuff tears are generally caused by falls, overuse, or normal aging. Often small tears will lead to larger tears in the future simply due to neglect of the initial tear. Patients with rotator cuff tears will usually have pain on the outside of the shoulder, up the neck or down the arm. Symptoms include the inability to raise one arm above shoulder level. Smaller, or partial thickness tears, can many times be treated without surgery. However, tears that are larger, or full-thickness, have a much higher chance of not healing and may require surgical intervention.