Rotator Cuff Repair:

The muscles of the rotator cuff are

• Subscapularis.
• Supraspinatus
• Infraspinatus.
• Teres minor

Most of the tears are encountered in the supraspinatus muscle. A tear can be either partial (articular-undersurface tear or bursal-oversurface tear) or full-thickness (complete detachment of the tendon from the attachment site over bone). Causes:

• Acute tear due to fall: An injury to the rotator cuff may occur suddenly when the patient falls on an outstretched hand or directly on the shoulder. This can be seen in slips and falls at home or in road traffic accidents.
• Repetitive Stress Injury: It may also develop over time due to repetitive activities. Repeating the same shoulder motions again and again can stress your rotator cuff muscles and tendons. Baseball, badminton, tennis, rowing, and weightlifting are examples of sports activities that can put you at risk of overusing tears. Many jobs and routine chores can cause overuse tears as well.
• Degeneration tear: the rotator cuff also grows old along with age. Degeneration occurs as we age. These weak tendons in old age can give away and tear even with very minimal force. Patients having trivial falls at home or in the washroom is the most common history given by patients.
• Bone spurs: As we age, bone spurs (bone overgrowth) often develop on the acromion bone’s underside. When we lift our arms, the spurs rub on the rotator cuff tendon. This condition is called shoulder impingement, and over time will weaken the tendon and make it more likely to tear.

Symptoms-

• In acute tears after a fall or injury, patients may feel a snap or pop at the time of injury and immediate weakness to lift the arm.
• Inability or weakness to lift the shoulder to the full extent is the most common symptom of full-thickness tears. Patients have more weakness than pain in full-thickness tears.
• Partial-thickness tear patients present with severe pain while doing overhead activities along with weakness in doing routine chores.

Tears that develop slowly due to overuse and repetitive stress also cause pain and arm weakness. You may have pain in the shoulder when you lift your arm, or pain that moves down your arm. Sometimes, due to radiation, patients complain of more pain in the midarm than in the shoulder. Pain may be mild and only present when doing overhead activities like lifting your arm over your head, such as reaching into a cupboard. Over-the-counter medication, such as paracetamol or diclofenac, may relieve the pain at first. Pain progresses and becomes continuous throughout the day. You may feel difficulty doing routine activities like combing your hair or reaching your hands to your back while bathing.
Treatment –
Proper, effective, and timely treatment plays a major role here. When a partial tear is neglected for a long time and not addressed appropriately, there are high chances of it getting converted into a full-thickness one and requiring surgery. Hence, rotator cuff tears progress over time. Early treatment can prevent your symptoms from getting worse and will help you get back to your routine activities of daily living.
Neglected cases of rotator cuff tear end up with wear and tear of the shoulder joint (rotator cuff arthropathy). The rotator cuff cannot be repaired at this stage, and patients require joint replacement (reverse shoulder arthroplasty).
Your doctor will consider your age, activity level, general health, and the type of tear you have in planning your treatment.