/ by Austin V. Stone, MD, PhD
A massive rotator cuff tear is a common shoulder injury, but it can leave you inactive and away from your favorite activities. Although traumatic massive rotator cuff tears are usually fixed soon after the injury, large, chronic tears can be more challenging to treat. A traumatic massive rotator cuff tear can commonly occur after a fall on an outstretched hand while a chronic tear may develop over time and is associated with weakness and nighttime shoulder pain.
If left untreated, a massive irreparable rotator cuff tear might lead to rotator cuff arthropathy, which is arthritis of the shoulder joint without a functioning rotator cuff.
Here are some ways that these tears can be treated, including a new innovative surgery:
How are massive rotator cuff tears usually treated?
We first typically treat chronic massive rotator cuff tear with physical therapy and anti-inflammatory medications. If those treatments don’t work, we consider surgery. However, surgery isn’t always the right option for certain tears.
What is superior capsular reconstruction?
Until recently, patients who could not undergo traditional surgery had few options. The good news is that there is a new arthroscopic surgery called superior capsular reconstruction.
During this minimally invasive procedure, your surgeon will place a graft inside your shoulder joint. The purpose of the superior capsular reconstruction is to improve the mechanics around the shoulder for better pain relief and function.
While the technique is still new in the United States, early results are optimistic in certain patients. Ideally, the surgery will help the muscles around the shoulder work more effectively so that patients can participate in physical therapy to improve the function of their shoulder.
Who can undergo this surgery?
Superior capsular reconstruction isn't the best path for everyone. Patients must have an irreparable rotator cuff tear but no significant arthritis. The presence of both of these conditions could limit the ability for the graft to heal and lead to more surgeries.
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