The rotator cuff is a group of tendons in the shoulder joint that provide support and enable a wider range of motion. Major injury to these tendons can cause a rotator cuff tear, which is one of the most common causes of shoulder pain in middle-aged adults and older individuals. Repeated overhead activities, sports injury, motor vehicle accidents, or sudden strain and/or fall can cause or aggravate a rotator cuff tear. Symptoms include severe pain, weakness of the arm, and crackling sensation when moving the shoulder in certain positions. There may be stiffness, swelling, loss of movement, and tenderness in the front of the shoulder.
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Specific Procedures
Arthroscopic rotator cuff repair
Arthroscopic rotator cuff repair is a minimally invasive surgical procedure used to repair symptomatic rotator cuff tears. Instruments are inserted through 1cm incisions and then tear can be fixed using anchors and/or sutures to approximate the torn tendon to its proper anatomic position on the bone.
Fully Torn Rotator Cuff Repair
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- Surgical Technique – Rotator Cuff Repair with Patch Augmentation
- Rotator Cuff Tears – Your Treatment Options
- Alternative Treatment for Rotator Cuff Tears
- Presentation and Exam of a Patient with a Rotator Cuff Tear
- Live Surgical Demonstration: Rotator Cuff Repair and Subpectoral Biceps Tenodesis
- Rotator Cuff Repair Live Broadcast Surgery
- Double Row Rotator Cuff Repair (no audio)
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- Use of Healing Factors to Help with Rotator Cuff Repair: Facts and Myths
- Partially Torn Rotator Cuff, Fully Torn Rotator Cuff Repair (Surgical procedures in 3D)
Post operative care
Rehab protocol
Partial thickness rotator cuff tear management
Partial thickness rotator cuff tears may not require surgery. Symptomatic relief may be obtained with conservative treatments like rest, anti-inflammatory medications, steroidal injections, and/or physical therapy.
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Biologic augmentation of rotator cuff tears
Massive rotator cuff tears present a challenge for tendon healing. Biologic augmentation of rotator cuff repair can be used as a surgical adjunct to improve healing outcomes. This can range from a tissue patch augment used in the repair to the use of stem cells to in principle, promote a better healing environment.
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- Biologic Augmentation of Rotator Cuff Tears
- Orthobiologics as an Adjunct to Rotator Cuff Repair (2021)
- Dr. Cole Lectures on the Use of Biologics to Improve Rotator Cuff Repair (2020)
- Clinical Application of Orthobiologics: RCR Augmentation
- Live Demonstration of Superior Capsular Reconstruction
- Biologic Association Presentation: Clinical Application of Orthobiologics – Tendons
- Biologic Association Presentation: Clinical Application of Orthobiologics – RCR Augmentation
- Dr. Cole’s use of stem cells during rotator cuff repair
- New Frontiers in Biologics
- Bone Marrow Aspiration from 2017 Chicago Sports Medicine Symposium | Brian Cole MD, MBA
Superior capsular reconstruction
Superior capsular reconstruction (SCR) is a surgical procedure used for the treatment of massive, irreparable rotator cuff tears in patients that do not qualify for a total joint replacement due to age and other factors. SCR uses a dermal allograft placed between the humerus and glenoid to reduce pain, restore function, and potentially prevent advanced rotator cuff arthropathy.
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Post operative care
Rehab protocol
Tendon transfer
In some cases, rotator cuff tears may be too large to reattach the rotator cuff to bone in the proper anatomic position. During tendon transfer, a tendon (typically either the pectoralis, latissimus dorsi or trapezius) is detached and then reattached at the rotator cuff area of the bone to duplicate the function of the rotator cuff.