Rotator Cuff Repair
The rotator cuff is the thick band of four muscles (called a tendon) that covers the top of the shoulder bone and holds in it place. These provide function and stability to the shoulder joint. They also allow for a full range of motion while keeping the ball of the arm bone in the shoulder socket. These tendons can become partially or completely torn. This is know as a rotator cuff tear.
These injuries may occur as a result of overuse of the muscles over a long period of time. As a result, this condition is most common in patients over the age of 40. It is also common in those who do repetitive lifting or overhead activities such as tennis players or carpenters. Rotator cuff tears can also occur as a result of a traumatic injury, such as a fall or sports injury. These tears typically involve pain when lifting or lowering the arm, muscle weakness and discomfort at rest (especially at night).
Some tears can be treated through nonsurgical methods that focus on relieving pain and restoring function to the shoulder. In many situations, the first line of treatment is a cortisone injection in the joint, followed by a course of Physical Therapy. However, in many cases, surgery will be recommended for tears that cause severe pain or that do not respond to these non-surgical treatments. The type of surgery performed depends on the size and location of the tear, but often involves trimming torn edges and suturing the tendon back together.
Most rotator cuff procedures can now be performed through arthroscopy, which uses a several tiny incisions rather than one large incision. This technique offers patients minimal trauma, less scarring and less damage to the surrounding muscles and tissue. The smaller incisions also result in less pain in the shoulder joint after the surgery.
During arthroscopic rotator cuff repair, the incisions are made in the shoulder, into which a thin tube and tiny instruments are inserted. The surgeon repairs the tendon through visualization on a television monitor. This technique also allows for shorter recovery times than the traditional, open surgical method. This type of more invasive surgery is now generally reserved for only very large or complex tears.
Dr. Guanche has developed a several methods for anchoring the sutures during the rotator cuff procedure. It is an improvement over the existing repair strategies typically used, taking the best elements of each. Named the mattress double anchor technique (MDA), this approach involves simplifying the repair process for the most secure anchoring of tendon to bone and has an exceptional success rate.