Management of partial thickness, full thickness, and massive rotator cuff tears continue to challenge the orthopedic surgeon. Recent advances in surgical techniques have evolved into complete arthroscopic rotator cuff repairs. The evolution of the all arthroscopic rotator cuff repair has been attributed to the ability of surgeon to recognize rotator cuff patterns, tendon immobilization and arthroscopic suture anchor placement and suture passing. Recent short term results have encouraging results and compare well to open rotator cuff repairs.
All arthroscopic techniques offer the patient less pain, a quicker recovery and less stiffness compared to the traditional open rotator cuff techniques. Arthroscopic techniques are more popular with shoulder arthroscopist with the goal of anatomic restoration of the tendon and optimal fixation.
The surgical goals of the all arthroscopic repairs over traditional open repairs are a more thorough diagnostic evaluation and treatment of intraarticular lesions. The diagnostic arthroscopic examination also facilitates a more thorough assessment and treatment of rotator cuff tears by approaching the shoulder from a different angle. Deltoid detachment that fails to heal following an open rotator cuff approach is a devastating complication and is totally eliminated with the all arthroscopic repair and in addition post-operative rehabilitation is accelerated if the deltoid does not need to be protected. Recent data does show better early range of motion and decrease postoperative pain.
The disadvantages of all complete arthroscopic rotator cuff repairs are that they are technically difficult, they require adequate experience, and there is a learning curve. The overall short term results are encouraging for all arthroscopic rotator cuff repairs. Patients do demonstrate a substantial improvement in function, decrease pain and satisfaction.
For more information, please contact Las Cruces Orthopaedic Associates, P.C. 575-525-3535. Ask for workman’s compensation specialist Kelly Sanchez ext. 136 for an immediate appointment.
Daniel A. Romanelli, MD