Alan M. Hirahara, MD, FRCSC
Orthopaedic SurgeonSpecialist in Sports Medicine

Rotator Cuff

The Rotator Cuff is one of the most common reasons for shoulder pain.  The rotator cuff is a set of four muscles and tendons that surround the glenohumeral joint, helping to dynamically stabilize the joint.  As the rotator cuff works, the humeral head maintains its position against the glenoid so the larger muscles can then make the arm move around this pivot point.  The shoulder can still function with a small or moderate tear, but commonly with pain.  Once a massive tear (2 - 4 tendons, with retraction and atrophy) occurs, then shoulder function will be severely compromised.  The ball will be unable maintain its position within the socket, and comparatively, the glenoid socket is quite small.

We can often repair these tears but as the tear size increases, the chances of success falls dramatically.  With today's technology, these repairs can all be done arthroscopically.  Emerging advances with OrthoBiologics has also significantly improved our chances of success with such innovations like PRP, ECM patches, DBM sponges, and, potentially, stem cells.  But even with the best of modern advances, when a certain tear size is reached, repair may not be possible.

A new emerging technique is the Superior Capsule Reconstruction (SCR), which has now been shown to be a outstanding salvage procedure to irreparable, massive rotator cuff repairs, which can restore joint stability and function, reduce pain, and prevent the need for a reverse shoulder arthroplasty.

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