Shoulder

Patients forms

Overview

Some rotator cuff injuries may require surgery to reattach torn tendons in the shoulder. In this procedure, the doctor inspects the shoulder with a small camera called an arthroscope. For small to moderate tears, the surgeon reattaches the tendons to the upper arm bone, or humerus, with strong stitches.

Step 1

The initial part of the procedure may be done arthroscopically through small tube. The surgeon may first use a small video camera to inspect the shoulder joint.

Step 2

The surgeon then removes any loose fragments of tendon or other debris form the damaged cuff tendon in the joint.

This procedure, called debridement, helps the surgeon inspect tissue damage in the joint and determine the need for more surgery. It is usually done arthroscopically.

Step 3

If there are bone spurs on the bottom of the acromion, the surgeon will use a rasp-like tool to smooth the area. This is called subacromial decompression, or smoothing, and will keep the acromion form pinching down on the supraspinatus tendon. It is usually done arthroscopically.

Step 4

If no tear is found in the rotator cuff area, the procedure may end here.

If a rotator cuff tendon is torn, repair is based on the size and severity of the tear. Small to moderate tears may be repaired arthroscopically. Very occasionally, open surgery may be needed to repair large tears.

The torn end of the tendon is cleaned up and an area on the humerus is cleared.

Step 5

The surgeon puts one or more small holes in the bone. This is either done with a drill or other sharp tool.

Anchors are then placed in the holes. These anchors are used to hold stitches in place on the arm bone.

Step 6

The tear in the tendon is stitched together. When the sutures are pulled tight to the anchors, the tendon reattaches to the humerus.

End of procedure

After surgery, the arm is usually placed in a sling. Physical therapy will be needed to regain full range of motion and increased shoulder strength. Over time, the tendon will naturally reattach itself to the humerus bone.