Partial Thickness Rotator Cuff Tear Repair

Degenerative, or “wear and tear” injuries where the tendon gradually becomes torn with long-term abrasion from the tissues on top of the tendon (called the acromion and coracoacromial ligament) are the most common form of partial tear.  These tendon tears cause pain with activities, including playing sports such as throwing a ball, hitting a golf ball, or overhead reaching with swimming.  They can also hurt at night.  Most of these tears respond to nonsurgical treatment, consisting of exercises, physical therapy, and sometimes corticosteroid injections.  Some of these tears do not respond, however, and require arthroscopic surgery, where a camera is introduced through tiny incisions and the tissues causing the tear are decompressed or reshaped (called a “subacromial decompression”) and the tear debrided (trimmed) or repaired.  Surgery for these tears is generally considered a last resort but is a successful measure to correct the problem.

If there has been an injury, including a fall from height, a lifting event, a car accident or other traumatic mechanism of injury, it is possible the tendon was forcefully pulled off the bone.  In these cases, critical force-transmitting tissue of the rotator cuff is detached, making the tear more painful, more refractory to exercise-based treatments, and potentially at risk of enlarging as the months and years pass.  While nonsurgical treatment for these injuries is typically initially recommended, it is at risk of not being successful, and therefore some of these injuries are treated more promptly with arthroscopic surgery to repair the torn tendon.

There are several surgical techniques using arthroscopic surgery to treat the partial tear.  Because of the variety of options available, it helps to have a high volume and experienced shoulder specialist like Dr. Obermeyer making the decision at surgery how to treat the tear. Sometimes, the tendon can be very minimally trimmed (called debridement) which can eradicate symptoms, or different techniques to repair the tendon, especially when more than 50% of the tendon thickness is involved(1). Partial tendon repairs can be done with a “trans-tendon” technique where the partially intact tendon is left in place and only the torn damaged tissue is reattached to the bone.  In other situations, the tendon is fully detached from the bone and the tear needs to be completed (called “take down”) and then reattached to the bone using specialized instruments.  Both techniques result in excellent outcomes to improve symptoms and prevent the tear from worsening.

Some partial tears can worsen(1), and it is important to know the risk of this in your particular case.  If you have been struggling with a tear and initial treatment has been unsuccessful to treat your pain, make an appointment with Dr. Obermeyer today for an expert evaluation to discuss your treatment options.

The surgery is done using a scope, or camera, inserted through tiny incisions. This is done a as a simple outpatient procedure under a light general anesthetic and a nerve block, where the shoulder is numb for several hours after surgery. There is a bandage worn for three days after surgery, and you can start showering. The recovery involves a sling for somewhere between two and six weeks to let the tissues heal (depending on the extent of the surgery) and early exercises are started to get the shoulder moving to prevent stiffness.  Most of the recovery is complete within three months of the procedure, however patients may experience improvements well up to a year after the procedure.

Like any procedure, there are inherent risks, including notably stiffness, which we work diligently to prevent.  Continued pain, need for further intervention, anesthetic complications, nerve or vessel injury are rare.  Minimizing the risks of surgery can be achieved with treating with Dr. Obermeyer, an expert high-volume surgeon serving the Schaumburg, Elk Grove, Bartlett, and surrounding communities to help ensure you achieve a favorable outcome with surgery for your partial thickness rotator cuff tear.