Rotator Cuff Tears
Tears of the rotator cuff tendons become more common as we age. Some of these tears produce no symptoms whatsoever, some give minimal symptoms and some give debilitating symptoms.
If a young person suffers a high energy trauma and tears a shoulder tendon, it is logical that this should be repaired with surgery. However, most people are not as easily categorised as definitely needing or not needing surgery.
Commonly, rotator cuff tears appear in middle-aged people who have some underlying degeneration of their shoulder tendons and are experiencing few symptoms. These cuff tears usually have not been caused by a violent injury.
After a thorough examination, Dr Scott will advise you whether it is necessary to have surgery to repair the rotator cuff tear. When examining and advising you, he will consider many factors including your:
- Physical condition
- Medical illnesses
In particular, Dr Scott will discuss your expectations of work and future hobbies. In general terms, having a persistently painful or weak shoulder with a rotator cuff tear may be a good reason to have surgery.
Most people who undertake surgery to repair a rotator cuff tear do well but it can take several months after the operation before you can return to heavy manual work or sports.
Despite the success of repairing tears, there is a recognised risk of painful stiffness or frozen shoulder following rotator cuff surgery. There is also a recognised risk of re-tear or partial re-tear of a repaired tendon.
Because rotator cuff tears may produce no symptoms at all, some patients consult specialists only when they have “massive” rotator cuff tears. There are generally two surgical possibilities for these large tears:
- Surgical repair of the tear, but this has a high failure rate and expectations of improvement are therefore more limited.
- A reverse shoulder replacement which is appropriate in older people, and is the only option when a massive rotator cuff tear is accompanied by shoulder arthritis.