By Dr. Howard Gelb
The rotator cuff, consisting of four muscles that support the ball of the shoulder in the socket, plays a crucial role as a dynamic stabilizer during various overhead motions and can become injured from either trauma or repetitive overuse. Historically, rotator cuff tears and disorders were primarily associated with older patients. However, with the increasing popularity of overhand sports, repetitive work tasks, weight training, and other activities, rotator cuff injuries are becoming more common among younger patients. The initial treatment for these injuries may involve relative rest and rehabilitation. Rotator cuff disorders may be classified into bursitis, tendonopathy without tear, partial tears, and full thickness tears.?MRI has become the diagnostic, noninvasive imaging modality of choice for evaluating cuff disorders.?Arthroscopy is still the gold standard for evaluating the integrity of the rotator cuff.?Treatment for partial thickness cuff tears may involve debridement (removal of the non healthy, torn fibers) or direct repair of the tendon. Full thickness rotator cuff tears are often treated by repairing the torn tendon back to the bone.?Using new techniques, even large, retracted rotator cuff tears can be repaired arthroscopically without opening the shoulder. This innovative approach to the rotator cuff is analogous to the development of other less invasive procedures such as laparoscopic surgery.?The arthroscopic cuff repair is routinely performed on an outpatient basis using a combination of general and regional anesthesia. For massive, irreparable tears, a reverse shoulder replacement can provide patients significant functional improvement. Post-operative treatment involves minimal immobilization combined with a structured rehab program.
Howard J. Gelb, MD
A board certified orthopedic surgeon specializing in adult and pediatric sports medicine and arthroscopic surgery. He has been in private practice since 1995.
Sports Medicine & Orthopedic Center
(561) 558-8898