Arthroscopic rotator cuff repair useful in treatment for recurrent traumatic shoulder instability
Shoulder dislocations are common at every age in adult life. In persons under 30, recurrent instability is likely the result of ligament and cartilage damage. However, in patients over the age of 40 years, recurrent instability is more than likely the result of a rotator cuff tear at the time of their shoulder dislocation.
These rotator cuff tears can be repaired arthroscopically to return shoulder stability. Initial treatment for a shoulder dislocation is emergent closed reduction with sedation. Following reduction of the dislocation, some people have persistent instability which may be manifested by persistent pain or uneasiness with the shoulder an overhead position. Alternatively, some people’s shoulder may continue to dislocate out of socket even despite immobilization in a brace.
Doctors Taylor Brown and Marc Labbe at the Bone and Joint Clinic of Houston have had great success with arthroscopic rotator cuff repair following traumatic glenohumeral joint dislocations that are associated with persistent instability. The two fellowship trained orthopedic sports medicine physicians are currently collecting their follow-up data in their prospective study on this complex subject. Early results demonstrate excellent return of motion and strength with no recurrent instability.
Standard arthroscopic rotator cuff repair techniques are used. Four small incisions are made around the unstable shoulder. Under arthroscopic visualization, the torn rotator cuff muscles and tendons are repaired back to the humeral head using absorbable suture anchors and stitches. The majority of these patients have torn supraspinatus and infraspinatus tendons. The remaining two rotator cuff muscles, the subscapularis and teres minor, usually remain intact and do not need an arthroscopic rotator cuff repair. As opposed to patients with small or medium sized rotator cuff tears, these patients with large and massive rotator cuff tears are placed into a prolonged period of immobilization before they begin a physical therapy course. Most patients need 6 months to fully recover after the arthroscopic rotator cuff repair. Final study follow-up data will be obtained at the two-year postoperative time period.
•
del.icio.us
digg
facebook