Rotator Cuff Tear Repair Surgeon in Salem Oregon

Like most tissues in the body, the rotator cuff is prone to degeneration over a lifetime of use.  Most tears are a combination of ‘wear-and-tear’ and more acute events.  Major trauma can also lead to a rotator cuff tear.  Degenerative tears can present without any specific events, while traumatic tears oftentimes present after a painful ‘pop’ in the shoulder.

Typically, the pain from a rotator cuff tear is over the lateral shoulder.  It can radiate into the scapula and into the front of the shoulder as well.  Usually patients with tears have difficulty with lifting the arm away from the body and overhead.  It is also common to experience pain at night and have trouble sleeping.  Some patients with larger tears may even have the inability to raise their arm overhead on their own.

The gold standard for diagnosing rotator cuff tears is MRI.  This type of scan utilizes a powerful magnet to create images of the anatomy deep inside the shoulder.  An ultrasound is another study that can reliably diagnose rotator cuff tears, though it is operator dependent and provides less information about the quality of tissue, tendon retraction, and muscle atrophy.  An X-Ray is another important study to assess for trauma and degeneration within the shoulder.

Multiple factors play into the best treatment options for a rotator cuff tear.  These include the chronicity (acute vs. chronic), size, retraction, patient’s health status, atrophy of the muscles, response to conservative treatments, patient’s age and activity level, and other associated issues within the shoulder.  

Physical therapy is recommended to help strengthen the surrounding muscles around the rotator cuff, to improve mobility, and to decrease pain.  You may do these exercises on your own at home or work with a licensed physical therapist. 

Injections, including cortisone and PRP (platelet rich plasma), can also be utilized to lessen the pain from a rotator cuff tear.  Care must be taken when considering more than one cortisone injection, as studies have shown how repeat injections may hamper the results of a subsequent surgical repair.  Injections do not have the ability to heal a tear.

I recommend surgical repair for patients with a full-thickness rotator cuff tear that have failed conservative treatment, for traumatic tears, and for younger active individuals.  The repair is done arthroscopically via small incisions, takes roughly 1-2 hours, and patients go home the same day.  Any other damage within the shoulder can be assessed and addressed at the time of surgery.  We see very high patient satisfaction and functional outcomes after arthroscopic rotator cuff repair, though it is important to understand that recovery takes about 6 months.  Patients are required to use a sling for 4-6 weeks after surgery, and are not allowed to strengthen the shoulder for at least 3 months.   

Some rotator cuff tears are termed ‘irreparable’, meaning they cannot reliably be fixed.  Clues a tear is irreparable include: very long-standing shoulder pain, previous shoulder surgery, massive tears, and tears associated with arthritis.  Surgical treatment options for these types of rotator cuff tears include partial repair, arthroscopic debridement, superior capsular reconstruction, tendon transfers, and reverse shoulder replacement.   

We take into consideration all of the anatomical and patient specific factors while making a treatment plan tailored to each patient’s specific situation.