Επιστροφή
Upper LimbRupture of the rotator cuff tendons is a common condition in adults, especially after the age of 40. It causes pain, limitation of shoulder movement and therefore significantly affects daily activities.
There are several ways to deal with it, which depend on the extent and severity of the rupture.
The most effective treatment is the surgical restoration of the rupture, which is now done with minimally invasive approaches, without the incisions and postoperative pain of the past, ensuring an optimal aesthetic and functional result.
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The rotator cuff of the shoulder is made up of the tendons of four muscles (the supraspinatus, the infraspinatus, the teres minor and the subscapularis muscles), which start from the shoulder blade and end in the humerus bone, surrounding its head.
A rotator cuff rupture is defined as the partial or complete rupture of the above tendons. This rupture is the result of either ,long-term tendon degeneration or injury and can have significant consequences for shoulder mobility, as well as, lead to arthritis.
The rupture of the rotator cuff tendons is usually due to a degenerative cause, due to chronic stress in the context of subacromial friction syndrome or from an acute injury, e.g. from lifting weights above the horizontal level of the shoulder joint.
There are two categories of rotator cuff ruptures: partial thickness and full thickness fractures.
Partial thickness ruptures do not concern the entire mass of the tendon, but only a part of it. In many cases, they are accompanied only by pain without affecting the movement of the shoulder.
In full-thickness or complete ruptures, there is rupture of the entire mass of the tendon, and in this case, the pain is often accompanied by the inability to lift the upper limb.
In both partial and total thickness fractures, pain occurs on the anterior surface of the shoulder, but can extend to the arm and shoulder blade. Pain is found when lifting the upper limb, but it can occur even at rest or during sleep.
The pain that manifests itself as a consequence of a rupture of the rotator cuff, restricts the movement of the shoulder joint and makes the patient’s daily activities difficult.
If total thickness tears are not treated, there is a high probability that they will grow in size and consequently lead to arthritis.
The method of choice for the diagnosis of rotator cuff rupture is MRI. In specific cases, shoulder ultrasound also provides important information.
Choosing the right treatment is extremely critical. In case of partial rupture of the tendons and for a limited period of time, conservative treatment of the disease is appropriate.
In particular, painkillers and anti-inflammatory drugs are taken by the patient in combination with physiotherapy and muscle strengthening. Based on the situation of symptoms after the end of conservative treatment, an evaluation is made for follow-up. If there is no improvement or on the contrary there is a worsening of the symptoms, then, surgical treatment is chosen.
In total ruptures, the choice from the beginning, is to suture the tendons arthroscopically and not with open surgery. It is very important to perform this operation arthroscopically, because it ensures less postoperative pain and better intraoperative control of the size of the rupture and its repair.
This is a minimally invasive approach, in which a small, one-centimeter-long hole is opened, instead of an incision. As a result, blood loss during surgery is significantly reduced and pain afterwords, is minimized.
When rotator cuff ruptures are treated surgically in time, success rates are over 90%.
Dr. Mazis and Dr. Pantos have many years of training and experience in highly specialized shoulder surgery centers in Germany.
For suturing the tendons, strong sutures and anchors are used, that enter the bone.
Implants used to repair rotator cuff rupture can be either, metal or bioabsorbable. At Osteon, our first choice is bioabsorbent implants.
The surgical restoration of the rupture of the rotator cuff tendons is performed under general anesthesia.
For the operation of arthroscopic suturing of the tendons of the rotator cuff, one day of the patient’s stay in the hospital, is required.
The patient’s return to daily tasks takes place 6 weeks after surgery.
The patient can return to sports activities and weightlifting, three months after surgery.
Shoulder surgeries require a great deal of patient discipline in the rehabilitation program that will be given to them. Especially in suturing tendons, there is a high risk of rupture if someone lifts weight earlier.
The success of the surgery is also at stake after it has been performed. For this reason, full compliance with the doctor’s instructions and the schedule he will have set for him is required.
If you are experiencing any pain or discomfort, please do not hesitate to contact us.