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Rotator Cuff
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The rotator cuff is
actually a set of four important muscles about the shoulder. These muscle are
difficult to see, being covered by both the much larger deltoid and trapezius
muscles. However, they are extremely important stabilizers of the shoulder
ball-and-saucer joint. Deconditioning of the rotator cuff muscles can
lead to abnormal motions of the shoulder joint and result in pain and weakness. Therefore, much of the
therapy for shoulder injuries is focused on restoring strength and stamina to
these important muscles. |
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The tendons of the
rotator cuff can be injured either by a one-time severe injury or slowly tear
by chronic overuse and inflammation. Once completely torn, these tendons
cannot heal without surgical repair. If no repair is performed, the size of
the tear increases slowly and the ends of the torn tendons get drawn further
and further apart with shortening and scarring of the tendons. As a result,
rotator cuff tears that have not been repaired for many years often become
irreparable - the ends of the tendons are just too short and scarred far apart
from each other to be brought back to each other to be repaired. In order to
prevent this from occurring, consideration should be given to surgical repair
of symptomatic full thickness rotator cuff tears when they are diagnosed. In the past,
repair of rotator cuff tears required an open procedure. Now, however,
techniques have evolved to allow this repair to be done arthroscopically
through small incisions and the use of a telescope by surgeons skilled in the
techniques of arthroscopic rotator cuff repair. |
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Example of intact rotator cuff viewed through the
arthroscope. The broad white tendon has no defect. |
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Example of rotator cuff tear viewed
through the arthroscope. The hole or defect in the tendon substance is the
tear. |
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Same view after arthroscopic rotator cuff repair. Note
that the defect is now closed with suture material. |
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