Rotator Cuff Re-tear
What is a Rotator Cuff Tear?
A rotator cuff tear is an injury where one or more of the tendons in the rotator cuff (the group of muscles and tendons that stabilize the shoulder and enable arm movement) become partially or completely torn. Injury to the rotator cuff may occur due to pressure on the rotator cuff from part of the shoulder blade (scapula). It may occur due to repeated use of the arm for overhead activities or while playing sports.
What is Rotator Cuff Re-tear?
A rotator cuff re-tear is an injury that may occur a few years after surgery due to multiple reasons including aging, a massive previous tear (more than 5cm), fatty degradation of the tendons, inflammatory arthritis, and inappropriate rehabilitation.
What is the Anatomy of the Rotator Cuff?
The rotator cuff is a group of 4 muscles in the shoulder joint that include the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles originate in the scapula and attach to the head of the humerus through tendons. The rotator cuff forms a sleeve around the humeral head and glenoid cavity, providing stability to the shoulder joint while enabling a wide range of movements.
What are the Symptoms of Rotator Cuff Re-tear?
A rotator cuff re-tear causes severe pain, weakness of the arm and a crackling sensation when moving the shoulder in certain positions. Lying on the affected shoulder may cause pain and discomfort.
What are the Causes of Rotator Cuff Re-tear?
Fat accumulation in the rotator cuff due to advanced age may cause a re-tear. Other causes include trauma, overuse injury or failure of the tendon to heal.
How is Rotator Cuff Re-tear Diagnosed?
Your doctor will assess your symptoms and order an X-ray. Two-point Dixon MRI may be ordered to identify the fat deposition in a rotator cuff.
What is the Treatment for Rotator Cuff Re-tear?
Your doctor initially recommends non-surgical treatment options including:
- Rest
- Shoulder Sling
- Pain medication
- Steroid injections
Physical therapy exercises will be taught for flexibility, range of motion and strength-building. The types of exercise involve stretching, ball squeezing and pendulum exercises.
Revision surgery is considered if you do not respond to conservative treatment options. It involves the identification of the healthy tendon and re-attaching it to the bone. Surgery is often combined with marrow stimulation healing response techniques (microfracture) or using orthobiologics such as PRP to promote healing.
How Can Rotator Cuff Re-tear Be Prevented?
Surgery involving double-row suture anchors, use of stem cell therapy, and collagen grafts can prevent a re-tear of the rotator cuff.
