Leon E. Popovitz, MD
Top-Rated Orthopedic Surgeon
Specializing in Arthroscopic Surgery of the Shoulder & Knee.
For appointments 212.759.4553

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The Importance of Catching a Rotator Cuff Tear Early

The Rotator Cuff is a group of important tendons in the shoulder that are responsible for the stability and strength of the shoulder. Rotator Cuff disease has various stages and levels of damage to these tendons. The symptoms are pain with overhead activities, night pain, biceps inflammation, weakness and limited motion.

The early stages of Rotator Cuff disease (called Impingement) is caused by pinching of the tendons by bone spurs above the tendons and, often, does not present with weakness. These bone spurs develop because of use and overuse with time. Some people are more prone than others based on the anatomical configuration of their bone which varies among different people. This stage can usually be treated with physical therapy and anti-inflammatory medications.

The progressing stages include Rotator Cuff Tears and can be caused by the constant pinching of the bone spur against the tendon. Moreover, a tear can occur as a result of trauma. This can cause significant weakness and, sometimes, difficulty raising the arm all together. This is commonly treated with a, minimally invasive, Arthroscopic Rotator Cuff Repair and can have excellent results when caught in time.

Very often, if not repaired, these Rotator Cuff tendons can retract like a rubber band rupturing. In addition, with time, these torn tendons can atrophy, leaving less and less actual tendon, and they turn into fatty tissue that cannot be repaired. Once there is significant retraction and atrophy of the torn Rotator Cuff tendons the prognosis of healing after a repair becomes very poor and, most often, repair can no longer be recommended.

If the tendons are not repairable then significant weakness can progress and arthritis can develop. If the arthritis becomes far advanced then a type of shoulder replacement can be performed in effort to salvage some quality of life.

Most recently, an innovative new surgery has been developed for those patients that have such severely retracted and atrophied torn Rotator Cuff tendons that they can no longer undergo repair. This procedure utilizes human cadaver freeze-dried and sterilized rotator cuff tissue as a patch to substitute for the patient’s atrophied tendons. So far the results are promising but, of course, not as good as repairing the patient’s own tendons.

Therefore, it is very important to diagnose a Rotator Cuff Tear promptly and if a repair is warranted then delaying may progress into far greater problems and difficulties.

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