Rotator Cuff Repair
In rotator cuff repair, your surgeon will begin by inspecting the shoulder joint. Then he or she will inspect the subacromial bursa, a small cushioning sac of fluid that surrounds the joint, followed by the rotator cuff itself. Arthroscopic shaver blades are used to clear away scar tissue, to shape the underside of the acromion (the bone at the top of the shoulder), and to smooth the edges of the cuff tear. Once the joint has been prepared, small anchors are attached to the bone. Sutures (stitches) are passed through the edge of the tissue, and the anchors are used to hold the stitch in place.
For years, shoulder instability has been treated with open surgery to repair the torn lip of the glenoid socket (the shallow hole of the shoulder blade where the ball of the upper arm sits), called the "labrum". Many surgeons now believe that instability is associated with more than just labral tears. Using minimally invasive arthroscopic techniques, your surgeon will have access to the entire joint. As a result, he or she can examine all potential tears and will base the method of repair (arthroscopic and sometimes open) on this thorough inspection. The arthroscopic repair is done using small incisions, which typically means your recovery is quicker and less painful than traditional open surgical repair.
To repair shoulder instability, your surgeon will attach anchors to the bone, then will pass sutures (stitches) through the tissue. The anchors hold the stitch in place. In many cases, these anchors are bio-absorbable and are gradually absorbed in the body over time (within three to five years following the procedure), rather than permanently residing in the bone. The surgeon may tighten the joint capsule using stitches or a radio frequency (RF) or thermal probe that heats the tissue, causing a molecular change in the collagen that allows the tissue itself to shrink.