ROCHESTER, Minn. — June 14, 2012. When shoulder pain doesn't respond to physical therapy, medication, rest or prescribed exercises, a range of surgery options can ease the rotator cuff pain or even rebuild the shoulder. The May issue of Mayo Clinic Health Letter provides an overview of rotator cuff injures and surgical repairs.
The rotator cuff is a group of four muscles that run between the ball of the upper arm bone and the shoulder blade. Tendons attach these muscles to the humerus ball. Normally, these muscles work as a group to keep the ball centered in its socket while the larger surrounding muscles make arm movement possible.
When rotator cuff muscles don't work properly, the result is pain and even disability. Pain is usually felt over the outside of the upper arm, just below the shoulder. Pain can have many underlying causes. Collagen, the tissue that serves as the building block for the rotator cuff muscles and tendons, weakens with age. Normal wear and tear or overuse of the arm may make the tendons and muscles more prone to degeneration and tears. Calcium deposits or arthritic bone spurs can form on the bones overlaying the rotator cuff. They can pinch the tendons and irritate the rotator cuff. A fall on an outstretched arm can bruise or tear a rotator cuff tendon or muscle.
A surgeon may recommend one of these repair approaches:
Open or mini-open repair: This includes detaching or splitting the overlying shoulder muscle (deltoid) to reach and repair a large or complex cuff tear. This is done through one incision over the shoulder or via several smaller incisions.
Arthroscopy: This surgery is done through very tiny incisions just big enough to accommodate pencil-thin surgical tools. This approach may be used to address worn or torn tendons, bone spurs that rub against worn tendons, or abnormal changes to the bursa, the tissue that covers and lubricates the top of the rotator cuff.
Reverse shoulder arthroplasty: When the rotator cuff is worn out or torn beyond repair, the shoulder ball can be replaced by a socket, and the shoulder socket by a ball. This complex procedure changes the shoulder joint mechanics so the arm can be moved comfortably without a functioning rotator cuff. Mayo Clinic surgeons have performed reverse shoulder arthroplasty since 2004 and have done more procedures than any other large medical center in the United States. When the procedure is performed by an experienced surgeon, most patients undergoing reverse shoulder arthroplasty experience pain relief and improved shoulder function.
Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.
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