The rotator cuff, comprised of tendons in the shoulder joint, provides crucial support and facilitates a broader range of motion. Severe injury to these tendons can result in a tear, known as a rotator cuff tear, which ranks among the most common causes of shoulder pain in middle-aged adults and older individuals. This injury often arises from repetitive overhead activities, sports participation, or motor accidents, causing severe pain, arm weakness, and a crackling sensation during shoulder movement. Additional symptoms may include stiffness, swelling, restricted movements, and tenderness in the front of the shoulder.
Magnetic resonance imaging is the preferred diagnostic tool for assessing rotator cuff tears. While conservative treatments such as rest, shoulder slings, pain medications, steroid injections, and specific exercises may provide symptomatic relief, surgical intervention becomes necessary to reattach the tendon to the shoulder bone.
Traditionally, rotator cuff repair surgery involved a large shoulder incision, approximately 6-10 cm long, with separation of the muscle covering the rotator cuff. However, advancements in surgical techniques have led to the development of minimally invasive procedures aimed at reducing pain and recovery time. Arthroscopic rotator cuff repair is one such procedure, performed through small incisions, each approximately 1 cm long, utilizing an arthroscope.
The arthroscope, a miniature fiber-optic viewing instrument equipped with a tiny lens, light source, and video camera, enables visualization of the joint during surgery. Despite their small size (only 3 or 4 mm in diameter), surgical instruments used in arthroscopic procedures appear larger when viewed through the arthroscope. The television camera connected to the arthroscope displays a detailed image of the shoulder joint on a screen, allowing the surgeon to assess cartilage, ligaments, and the rotator cuff. Based on this assessment, the surgeon can determine the extent and type of injury and proceed with the necessary repairs or corrections.
Arthroscopy offers several advantages over open shoulder surgery, including smaller incisions, minimal soft tissue trauma, reduced pain, faster healing, lower infection risk, less scarring, earlier mobilization, and often, outpatient day surgery status.