Does a Rotator Cuff Tear Require Surgery?
Inflamed rotator cuff tendons or smaller, partial rotator cuff tears may recover with non-surgical treatments. These treatments include resting the shoulder, ice therapy, and physical therapy. In some cases, steroid injections or platelet rich plasma (PRP) injections can also help reduce inflammation and pain.
Most full thickness rotator cuff tears in otherwise healthy people are better treated with surgery as these tears will not heal and will only get larger, more retracted, and worsen over time. If one waits too long, a torn rotator cuff tendon may be so far retracted from its normal attachment site on the bone, that it can no longer be surgically repaired, and then other salvage type surgical options may be required. There are several surgical treatment options, depending on the condition and expected outcome for the individual patient. These include:
- Arthroscopic tendon repair: Most patients are treated with an arthroscopic rotator cuff tendon repair. In this treatment, minimally invasive tools and techniques are utilized to reattach a torn tendon to its normal attachement on the top of the humerus bone. Recovery time is quicker compared to open procedures.
- Superior Capsular Reconstruction: For patients with massive, retracted rotator cuff tears where the tendon can no longer be stretched back over to its normal attachment site, a donor tendon may be arthroscopically implanted in its place. This is a fairly new procedure that Dr. Cunningham has been doing for these more difficult types of tears.
- Shoulder replacement: For patients with large, severely retracted rotator cuff tendon tears that are no longer repairable and when there is also arthritis in the shoulder, then a special type of shoulder replacement called a reverse total shoulder arthroplasty would be considered. This surgery is typically done in older individuals and they can do well with elimination of most pain and a return to reasonable shoulder function.
Dr. Cunningham is a shoulder specialist at Vail Summit Orthopaedics. He is an expert at diagnosing and treating rotator cuff tears for patients in Vail, Summit County, Aspen, and Denver, CO. Contact Dr. Cunningham today.