Capital City Orthopaedics and Sports Medicine

Rotator Cuff Tear Surgery in Atlanta

One of the most flexible joints in the body, the shoulder is a complex mechanism of bones, muscles, tendons, and ligaments. The coordinated function of these various components allows the arm a wide range of motion and rotation; however, the great flexibility of the shoulder also makes the joint relatively unstable and vulnerable to injuries, such as dislocation.

Affecting millions each year, a common point of injury within the shoulder is the rotator cuff. Injuries to the rotator cuff will weaken the shoulder, and result in many daily activities, such as getting dressed, becoming painful.

What is the Rotator Cuff?

The rotator cuff is a group of four muscles (Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis) that meet to form a covering around the head of the humerus (upper arm bone) and hold the humeral head in the shoulder socket. The rotator cuff is also instrumental in lifting and rotating the arm. A lubricating sac, called a bursa, lies between the rotator cuff muscles and the bone on top of the shoulder (acromion), and allows the rotator cuff tendons to glide smoothly during arm movement.

How Can a Rotator Cuff Tear Occur?

Rotator cuff tears can result from a number of factors; however, these factors fall within three main categories: traumatic injury, overexertion, and degenerative wear-and-tear.

• Traumatic Injury: These rotator cuff injuries are the result of a single, traumatic event that puts great stress on the shoulder, such as a fall on an outstretched arm, the impact from a football tackle, or the lifting of a heavy object with a jerking motion. Rotator cuff tears from this category of injury often occur with other shoulder injuries, such as dislocation or a broken bone.
• Overexertion: Rotator cuff tears from overexertion result from the stress of a repetitive arm motion. Athletes, such as baseball pitchers, tennis players, weightlifters, and rowers, are commonly affected by rotator cuff injuries due to overexertion. Other professions that require constant, repetitive arm motion, such as painting, can also lead to rotator cuff tears.
• Degenerative Wear and Tear: Wear-and-tear as the result of aging can also lead to rotator cuff injuries. As a person ages, the blood supply within the tendons lessens. The diminished blood flow results in weakened rotator cuff tendons that can ultimately lead to a tear. Additionally, age can lead to the development of bone spurs, which rub against the rotator cuff. This condition, called shoulder impingement, can also lead to a rotator cuff tear over time.

Rotator Cuff Tear Diagnosis and Treatment

A patient suffering from a possible rotator cuff tear can often identify the traumatic event or repetitive motion that led to the injury. A rotator cuff torn through a traumatic event will often be accompanies by intense pain, a "snapping" sensation, and immediate weakness or loss of function in the shoulder and upper arm.

Common symptoms of a rotator cuff tear resulting from degenerative wear-and-tear include:

• Pain when lying on the affected shoulder
• Pain when lifting and lowering the arm
• Weakness when lifting or rotating the arm
• "Crackling" sensation during shoulder movement

An orthopaedic surgeon, such as Dr. Fowler, can properly diagnose the cause of a patient's chronic shoulder pain or potential torn rotator cuff. After discussing symptoms and medical history with the patient, Dr. Fowler will examine the affected shoulder for tenderness or deformity and move the arm through a range of motions to determine which movements cause pain. Dr. Fowler may use imaging technology, such as an x-ray or MRI, to further confirm the diagnosis.

Depending on the severity of the rotator cuff injury, Dr. Fowler may initially recommend conservative, non-surgical treatment methods. Potential approaches include: rest, activity modification, medication, or physical therapy exercises, including Tai Chi or Pilates. These non-surgical treatments may sufficiently alleviate shoulder pain for the patient.

As a rotator cuff tear can worsen over time, Dr. Fowler may recommend surgery to repair a torn rotator cuff. Likewise, a severely torn rotator cuff will require surgical intervention for proper treatment.

What is Shoulder Arthroscopy?

Shoulder arthroscopy is a minimally invasive surgical technique that may be used to repair a torn rotator cuff. As a minimally invasive procedure, arthroscopic surgery may provide patients several benefits compared to traditional open surgery, including minimal tissue damage, less scarring, and a shorter recovery from the surgery.

During the arthroscopic procedure to repair a torn rotator cuff, Dr. Fowler will insert a fiber optic camera (arthroscope) into the shoulder through a small incision. The arthroscope allows Dr. Fowler to view the joint from within for final diagnosis of the extent of the tear. Miniature surgical instruments will be inserted through small secondary incisions to repair the torn rotator cuff.

Read more about Shoulder Arthroscopy >>

Rotator Cuff Tear Surgery Recovery

After surgery, a regimen of rehabilitation exercises is necessary to regain the mobility and strength of the shoulder. With dedicated rehabilitation, a surgically repaired shoulder will redevelop proper function and range of motion in four to six months for many patients.

Rotator Cuff Surgery in Atlanta, GA

Dr. David Fowler is a Board-certified orthopaedic surgeon who utilizes conservative and alternative methods for the treatment of joint pain and injuries; however, when surgery is required for proper treatment, Dr. Fowler specializes in the latest minimally invasive and arthroscopic techniques. Please call Dr. Fowler's Atlanta office at (404) 303-8665 to make an appointment.