Shoulder surgery for torn rotator cuff often uses anchors

February 9, 2010 — admin

My son is going to have a rotator cuff tear repaired surgically. The doctor described a special anchor suture that will be used to hold the tendon in place until it heals. What kind of problems can come from using these anchors?

Rotator cuff tears are often repaired using some kind of anchor or suturing system. The fixation devices are called suture anchors. They work like rivets to reattach the tendon to the bone. These anchors can be made of bone, metal, or plastic.

Problems differ depending on the type of anchor material used. For example, some anchors (like the bone buttons) require a hole predrilled before insertion. This extra step makes for a longer operation. Sometimes the surgeon has trouble making and then finding and using the hole.

Anchors made of bone are usually absorbed by the surrounding bone and don’t have to be removed. Plastic anchors may also “dissolve” or get absorbed by the bone. Some metal anchors are held in place by threads or barbs. These do not resorb and can cause problems if they move or come loose.

Other problems can include breakage of the anchors, anchor pullout, infection, or rerupture of the tendon. Infection and poor wound healing are problems in a small number of cases. Usually, these patients have diabetes or some other healthy issues or they are tobacco users.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Osteoporosis may cause rotator cuff repair to fail

December 24, 2009 — admin

I’m 78-years old and have been diagnosed with a rotator cuff tear and osteoporosis. I’ve been told the osteoporosis puts me at risk for a failed rotator cuff repair. If the muscle is the problem, what difference does it make if the bones are brittle?

The tendons attach to the bone and must be reattached after injury in order to give you back shoulder motion and strength. Some of the newer ways of repairing rotator cuff tears involve drilling holes through the bone. Then the doctor threads the sutures through the tunnel to the other side. This gives the repair strength and the shoulder stability.

The sutures may not hold if the bone is soft or brittle from osteoporosis. In cases of bone problems, they can use special anchors that look like buttons to help hold the stitches in place.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Three factors affecting rotator cuff surgery recovery

November 19, 2009 — admin

There were two employees in our office who had surgery to repair a torn rotator cuff in the shoulder. One person had a great result and has come back to work already. The other worker is still off with pain, depression, and loss of function. How do you account for the differences?

Many things can affect the outcome of rotator cuff repairs. First, the severity of the tendon tear is important. A full tear can require a more complicated operation. A partial tear with a small repair may heal faster and rehab sooner.

Second the type of surgery makes a difference. Did the doctor use an arthroscope and go into the joint with a special tool to make the repair? Or was a full cut needed to open the joint up? Arthroscopy usually means faster recovery.

Third, what’s the general health of the patient? Anyone with other health problems may be facing some extra complications. For example the client who has diabetes, high blood pressure, or lung or heart problems may have some special problems after the operation. There’s always a concern about infection, poor wound healing, and blood clots after an operation of any kind. Patients with any of the problems listed here can be at increased risk for these complications.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Best form of surgery for torn rotator cuff depends on location

October 15, 2009 — admin
I have a moderate rotator cuff tear. I haven’t had relief from physical therapy and medications. Now we’re talking about surgery. My doctor says there are a couple of ways to approach surgery for tears like mine. What type of surgery is best?

 
There are a few ways to operate on rotator cuff tears. The most extensive surgery is open repair of the rotator cuff. With this procedure, surgeons use a large incision to operate. During surgery, they suture the tear to help the shoulder function properly. This approach is the best option for severe tears, or those that affect more than half of the rotator cuff tendon.

An alternative for minor tears is called acromioplasty. With this procedure, surgeons shave part of the acromion bone on the point of the shoulder. A ligament over the top of the shoulder is cut, and injured tissues are removed. This takes pressure off the injured rotator cuff and promotes healing. For patients with tears that affect less than half of the tendon, this procedure usually have good, lasting results.

For patients whose tears go through about 50 percent of the tendon, repair of the rotator cuff may offer better results than acromioplasty. This choice also depends on where the tear is located. Ask your doctor which surgery is best, given the size and location of your injury.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Testing for tears in rotator cuff not always accurate

September 24, 2009 — admin
The arthrogram for my shoulder showed no tear in the rotator cuff. But when I went for an MRI, it showed a complete tear. Why didn’t the arthrogram show the tear?

 
The arthrogram is an older test. It is based on the idea that a special dye will leak out if the rotator cuff is torn. If a scar forms over the tear or if the dye can’t leak out for some other reason, the test will appear negative. This is known as a “false negative” result, meaning the test appears normal even though the tendon is actually torn. 

A “false positive” is when a test shows there’s a problem where there isn’t one. For example, because the MRI scan is so sensitive, it can sometimes show what looks like a tear. Yet when surgery is performed to fix the tear, the surgeon may find that the tendon is not torn.

The most accurate test of all is surgical exploration. However, because surgery is costly and has certain risks, doctors prefer to use tests like MRI first to try to confirm the presence of a tear.

 
The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

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Is it safe to play tennis after tearing one of my rotator cuff tendons?

August 7, 2009 — admin

August 7, 2009 I tore one of the rotator cuff tendons in my left shoulder six months ago. I faithfully went to physical therapy and did my exercise program for the first two months. Once the pain was gone and I could move the arm freely, I stopped doing the exercises. Is it safe now to sign up for tennis lessons?

If you still have full motion without pain or other symptoms, you are probably safe to begin tennis. There is a risk of future injury, but there is no way to predict this. Warming up before exercise or activity (including tennis) is always a good idea. Spend about five or 10 minutes stretching the muscles of both shoulders, and move your arms through various tennis motions gently and slowly. Your therapist can retest the strength of your shoulder and prescribe a specific warm-up and exercise program for you. This may be a good way to prevent future injuries while still enjoying the fun of tennis.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

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Does the size of a rotator cuff tear affect the success of surgery?

July 23, 2009 — admin
I have a very large tear in my rotator cuff, and I’m going to have surgery to fix it. Does the size of the tear make a difference in whether the results of surgery will last?

 
It’s possible that the size of the tear will make a difference in the surgery’s success. A recent study followed patients who had this kind of surgery at age 55. Ten years after surgery, researchers checked on patients’ pain, level of function, and shoulder strength.

All of the patients who had small or medium-sized tears had excellent results from surgery ten years later. Patients who had large tears also had good or excellent results. These numbers changed somewhat for the 11 patients with massive tears. There were seven excellent results, one good result, and three unsatisfactory results.

From this study, it looks like the chance of having an unsatisfactory result goes up slightly as the tear gets bigger. However, there’s still a good chance of having a positive result. Ask your doctor what kind of results you can expect, given your age and condition.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com 

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What is a rotator cuff and how does it get torn?

July 23, 2009 — admin
I recently fell and hurt my shoulder. The doctor told me that I have a rotator cuff tear. What is the rotator cuff, and what part is usually torn?

 
There are four muscles that make up the rotator cuff. The tendons from each muscle encircle the top of the shoulder, much like the cuff of a sleeve goes around the entire wrist. The rotator cuff holds the humerus in the socket of the shoulder joint while still allowing it to turn, or rotate (hence the word “rotator”).

Usually only one or two tendons of the rotator cuff are torn. The tear commonly occurs close to where the tendon attaches to the bone. It is rare for all four tendons to be injured at the same time.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com 

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