Impingement, Rotator cuff/biceps tendon tear and arthroscopic surgery

There are a number of different problems that can affect the rotator cuff and lead to rotator cuff injury or inflammation. The most common problems include:

  • Rotator cuff tendonitis
  • Rotator cuff impingement syndrome
  • Rotator cuff tear
  • Partial tear of the biceps tendon (Pulleylesion)

Symptoms caused by a rotator cuff tear may be successfully eased with non-surgical treatments, including rest, physiotherapy, painkillers, anti-inflammatories and steroid injections. Surgery may be considered when troublesome symptoms persist despite the above treatments. In terms of the first two diagnosis or small partial tears,  a subacromial decompression (widening of the space underneath the acromion) may be sufficient. The operation aims to increase the size of the subacromial area and reduce the pressure on the muscle. It involves cutting the ligament and shaving away the bone spur on the acromion bone. This allows the muscle/tendon to heal.

Pictures: x-ray pictures right shoulder: before and after subacromial decompression

Pictures: arthroscopic view subacromial spur: while and after subacromial decompression

In case of larger tears or when more than one tendon, including the long biceps tendon are involved, repair of the rotator cuff tendon/s are required.

The procedure will be performed ambulatory. The surgeon inserts a thin tube (arthroscope) containing a camera and a light through small incisions near the shoulder and is able to see inside the shoulder without making a large incision. Surgical instruments can be inserted through other small incisions and the torn parts of the rotator cuff will be reconstructed. Due to the arthroscopic gentle kind of operation most patients are able to go home  the day of their surgery.  Following the procedure you will stay in a hotel with daily consultations in our outpatient clinic and then begin a training program that has been carefully coordinated with the healing process.  To ensure an optimal healing process, patients are required to wear a splint for approximately four weeks.

Pictures: arthroscopic reconstruction of the long biceps tendon