SHOULDER ARTHROSCOPY

Q:

I have been diagnosed with a rotator cuff tear and surgery has been recommended. What size incisions can I expect and what is the recovery time?

A:

The technical aspects of rotator cuff repair involve placing small screws in the upper portion of the arm bone (humerus) where the rotator cuff tendon normally attaches. The screws are called suture anchors and are made from a special form of biodegradable plastic that the body will naturally absorb over time. The suture anchors are armed with high strength sutures that are then placed through the torn tendon, and through a variety of pulleytype techniques the tendon is returned back to the bone at the location of the anchor.

The advent of arthroscopic techniques has provided improved access to the rotator cuff using small instruments with the assistance of video technology, allowing for treatment of the rotator cuff through a few tiny incisions without trauma to the overlying deltoid muscle. In addition to reduced pain from the minimally invasive nature of the surgery, arthroscopy affords the surgeon greater visualization of rotator cuff tear patterns as the arthroscope can reach places that are not easily seen with open surgery. Today, virtually all rotator cuff repair surgery is performed through arthroscopic techniques.

Even after the rotator cuff tendon has been repaired back to the humerus bone, optimal success from the operation is not achieved unless there is true biologic healing of the tendon back down to the bone. This is a process that occurs very slowly over time thus explaining the need for strict protection of the shoulder following surgery.

Patients are placed into a specialized sling which they are expected to wear for 4 to 6 weeks after surgery. The sling can be removed for bathing and changing clothes and for appropriate physical therapy, but no purposeful, active movement of the shoulder is permitted as this can compromise the healing process. The optimal approach to physical therapy following rotator cuff repair remains a topic of ongoing research without widespread consensus. Most research favors a very slow progression of therapy, with a brief period of complete rest followed by several weeks of passive movement of the shoulder where the patient does not assist in the movement of the arm. Over time active lifting of the arm is permitted followed by a program of strengthening.

To watch a video of Dr. Parsons performing arthroscopic rotator cuff repair visit www. ohioshouldercenter.com.

Eric M. Parsons, M.D.

Ohio Shoulder Center for Arthroscopy Lake Orthopaedic

Associates, Inc. 36060 Euclid Ave., Suite 104

Willoughby 440-942-1050 9500 Mentor Ave., Suite 210

Mentor 440-352-1711 www.ohioshouldercenter.com