Rotator cuff tear (RCT)

Overview

The rotator cuff is a group of four muscles that move and stabilize the humerus (arm bone) in the shoulder joint. The four muscles are supraspinatus, infraspinatus, subscapularis and teres minor muscle. The supraspinatus tendon is the most common tendon where tears happen. There are two main causes of rotator cuff tears: acute injury and degeneration.

  • Acute injury: Acute RCT may happen due to trauma. For example, when your fall down on outstretched arm or lift something heavy with a jerking motion.
  • Degenerative tear: Most tears happen due to wearing and degeneration of the tendon. Several factors contribute the tear, such as repetitive tendon stress, bony spurs of acromion or lack of blood supply due to aging.

Patient may experience arm weakness due to tendon tear. In addition, the patient may feel painful because of the inflamed shoulder bursa.

 

Features

The rotator cuff repair was done to regain the strength and decrease the pain of shoulder.

 

Procedure

The goal of rotator cuff repair is to re-attach the torn tendon to its anatomic insertion. It is performed arthroscopically with minimal incisions. There are about 4 small incisions made on the skin of the shoulder for the device of arthroscopy to work. With the technique of arthroscopic surgery, the whole shoulder is fully examined. The doctor will identify the edge of the tears of rotator cuff and debride the inflamed bursa or synovium. The anatomic insertions of the rotator cuff tendons are prepared with a burr to create a bleeding bed. Then the suture anchors are implanted into the prepared insertion of humerus. Sutures of the anchors are passed into the edge of the torn tendon. The rotator cuff tendon is then pulled over the insertion and tied securely. The biceps tendon is also checked. Tenotomy or tenodesis of the biceps tendon will be performed if necessary. In addition to rotator cuff repair, the subacromial decompression will also be performed to remove the spur of the acromion with a burr, preventing further impingement of rotator cuff.

After the surgery, shoulder protection with an arm sling for 6 weeks is required. The doctor will arrange the rehabilitation protocol in the following months.

 

Notification

Complications are not common but can occur.

  • Joint stiffness: Most common. Most of the stiffness ended in 6 to 12 months after the surgery.
  • Infection: 1%
  • Allergic reactions to medications
  • Excessive swelling & Bruising
  • Damage to nerves or vessels: 1~2 %

 

Estimated Cost

The procedure cost is about 264,000 NTD, prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.

A shoulder joint that was viewed arthroscopically. The rotator cuff is tear. Rotator cuff repair with suture anchors. The tendon is reattach to the humeral head.
 
The surgery is performed arthroscopically. The wound of Rotator cuff repair