Diagnosis
How is a rotator cuff tendon rupture diagnosed?
A Rotator cuff rupture is diagnosed using Magnetic Resonance Imaging (MRI). In certain cases, shoulder ultrasound also gives important information.
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Rupture of the rotator cuff tendons is a common condition in adults, especially after the age of 40. It causes pain, limited shoulder movement and therefore significantly affects daily activities.
There are several treatments available, depending on the extent and severity of the rupture.
The most effective way of treatment is the surgical repair of the rupture, which is now performed with minimally invasive approaches, without incisions and postoperative pain as in the past, ensuring optimal aesthetic and functional result.
The rotator cuff of the shoulder consists of four distinct muscles and their tendons (the supraspinatus, infraspinatus, the subscapularis and the teres minor), which start at the shoulder blade and end at the humerus, surrounding its head.
Rupture of the rotator cuff tendons usually has a degenerative cause, due to chronic strain within the context of Subacromial impingement or acute injury, e.g. caused by lifting weights above the horizontal level of the shoulder joint.
Rupture of the rotator cuff tendons usually has a degenerative cause, due to chronic strain within the context of Subacromial impingement or acute injury, e.g. caused by lifting weights above the horizontal level of the shoulder joint.
There are two categories of rotator cuff ruptures: partial thickness tear and full thickness tear.
Partial thickness tears do not involve 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 tears, there is a rupture of the entire mass of the tendon, and in this case the pain is often accompanied by an inability to lift the arm.
In both partial and total thickness ruptures, the pain occurs on the anterior surface of the shoulder, but may extend to the arm and shoulder blade. Pain appears when lifting the arm but it can occur even at rest or during sleep.
The pain that appears as a result of a rotator cuff rupture, limits the movement of the shoulder joint and complicates patient’s daily activities.
If full thickness ruptures are not treated, there is a good chance they will get worse and consequently lead to arthritis.
A Rotator cuff rupture is diagnosed using Magnetic Resonance Imaging (MRI). In certain cases, shoulder ultrasound also gives important information.
Choosing the right treatment is extremely important. In case of partial rupture of the tendons and for a limited period of time, conservative treatment of the disorder is considered appropriate.
In particular, painkillers and anti-inflammatory drugs are administered to the patient in combination with physiotherapy and muscle strengthening. Based on the picture of the symptoms after the end of the conservative treatment, an evaluation is made in order to see what are the next steps to be taken. If there is no improvement or on the contrary the symptoms worsen, then the surgical treatment is chosen.
In total ruptures, the first choice is to reattach the tendons arthroscopically and not with open surgery. It is very important to have this operation arthroscopically, because it ensures less postoperative pain and better intraoperative control of the size of the rupture and its restoration.
This is a minimally invasive approach, through a small skin incision of one centimeter. As a result, blood loss during surgery is significantly reduced and postoperative pain is minimized.
When rotator cuff ruptures are treated in time surgically, success rates are over 90%.
Dr. Pantos have many years of training and experience in specialized shoulder surgery centers in Germany.
For the stitching of the tendons strong stitches and anchors which are inserted into the bone are used.
The implants used to repair the rotator cuff rupture can be either metal or bioabsorbable. At Osteon our first choice is bioabsorbable implants.
Surgical restoration of the rotator cuff tendons rupture is performed under general anesthesia.
For the operation of arthroscopic suturing of the rotator cuff tendons the patient is required to remain in the hospital for 1 day.
The patient returns to daily activities 6 weeks after surgery.
The patient can return to sports activities and weight lifting, three months after surgery.
Shoulder surgeries require a great deal of patient discipline regarding the rehabilitation program that will be given. Especially, concerning the stitching of the tendons, there is a high risk of breaking if the patient lifts weight earlier than suggested.
The success of the surgery is at risk even after it is completed. That is the reason why full compliance with doctor’s instructions and the program he has set is required.