Patients Find Satisfaction in Surgical Breakthroughs for the Rotator Cuff
Authors: William F. Bennett
References: Arthroscopy. April 2003. Vol. 19. No. 4. Pp. 380-390.
If given the chance, would you have the same surgery again? Doctors find this a useful measure of success. Dr. Bennett of Sarasota, Florida, asked 37 patients this question after shoulder surgery.
Each patient had a massive tear of the rotator cuff. The rotator cuff is a group of four muscles and their tendons that surround the shoulder. The repair was done by arthroscopic surgery. The doctor used a special tool to enter the shoulder joint without a large incision. A tiny TV camera at the end of the arthroscope allows the doctor to see inside the joint and make repairs.
All but two patients were happy with the results of their surgery. They said that they would do it again to get pain relief and increased motion. Dr. Bennett reports that newer repair methods make it possible to repair massive tears. In the past, some of these damaged tendons couldn't be saved.
The arthroscope makes it possible for the doctor to find the torn tendon and slide it back in place. Sometimes there isn't enough tissue to reattach it to the bone in the right place. New ways to reconstruct and reshape the rotator cuff make it possible to restore function in such cases.
For example, when repairing a large tear, the surgeon uses as many side-to-side stitches as possible. This is called margin convergence. With margin convergence, less tissue is needed to reattach the tendon to the bone.
Not all rotator cuff tears can be repaired. However, the arthroscope gives the doctor many more options to try. Most patients are happy with the results and would have the surgery again.