Rotator Cuff Tear

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[edit] Rotator Cuff Tear

A logical consequence of chronic rotator cuff tendinitis is that the inflamed tissue of the rotator cuff gets scarred up and brittle and eventually ruptures. This usually is a very sudden event and often occurs when the person wants to lift something heavy. However, there can be only a partial tear of the rotator cuff, which can heal on its own or can be repaired with shoulder arthroscopy as shown in this link.

At other times though it can be a chronic slow deterioration and only testing such as an arthrogram of the shoulder (a special X-ray following the injection of a dye) will show that there is a hole in the rotator cuff. A shoulder MRI is also very useful to see how big the hole is. Arthroscopy is used for a repair of a rotator cuff tear and is best done by a shoulder surgeon. The surgeon can often fix this by sewing it over with a few sutures that are anchored as shown in the links of this link. However, sometimes there is not enough healthy tissue to do this surgery.

Even with successful surgery the overall result is often less than satisfactory as the scarring after the surgery leads to a relative shortening of the rotator cuff tendon and the range of motion in the shoulder suffers somewhat. However, strength is usually restored with surgical repair giving the patient the feeling that things are more like normal again (Ref. 2).

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.

3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

5. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

6. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/ Several topics can be found under this link by entering the term you search for.