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Rotator cuff is a group of tendon which gives movement to shoulder joint. Its primary function is to lift the shoulder up rotator cuff tear are mostly degenerative tears and are seen in elderly patients. But young people can also have a rotator cuff tear, in these cases its mostly traumatic.
We do arthroscopic rotator cuff repair. Our preferred technique is a double row rotator cuff repair under general anesthesia with a regional block.
In this the retracted tendon is brought back to its native place and fixed to the tuberosity using suture anchors in double row configuration. The advantages of this technique are that its relatively pain less and we can go for accelerated rehab because of strong double row fixation.
For irreparable rotator cuff tears, we do an arthroscopic superior capsular reconstruction. In this the humeral head is prevented from superior migration either by using bio mesh or rerouting of the biceps tendon. This procedure prevents the superior migration of humeral head thus significantly decreasing the chances of shoulder arthritis.
Just like surgical precision, post-operative physical therapy is very important for a successful rotator cuff repair. According to our protocol the patient is kept in a shoulder pouch for 3 weeks, but is allowed to start doing exercises from day 1. Assisted flexion is allowed from day 1 and patient is encouraged to use his/her hand for his day to day activities with few precautions Rom exercises are started after 1 month followed by strengthening exercises. In three months, the patient is able to use their hand normally in most of the cases.
Superior migration of head can lead to shoulder arthritis known as rotator cuff arthropathy and need for reverse shoulder replacement.