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What will happen during your surgery

Rotator cuff surgery is usually performed using an arthroscope.  This instrument allows your doctor to repair your shoulder through very small incisions.

I’d like to tell you about rotator cuff repair, and I’m also going to show you an MRI scan which is a special study that we do in order to diagnose rotator cuff tears because they show us not only the bones but they also show us the deep tendons in the joint.

(Camera moves to close up of MRI scan) So this is a typical MRI of a shoulder that has a very small rotator cuff tear, but I think it shows it very nicely. This is the ball of your shoulder (gestures in a circular motion on the MRI scan), and this is the socket of your shoulder (gestures in a curved motion to the left of the ball area on the MRI). The rotator cuff muscles, you can see here nicely (gestures to a dark area of MRI scan between the ball and the socket), and they attach to a dark tendon (gestures to a dark curved line on the MRI scan.) I can move front and back on this MRI to really get a more 3-dimensional image of this tendon. This also allows me to diagnose the tear.

So what I’m going to do is start scrolling more forward on this shoulder and I’m going to point to the tendon so you can see it. This is the tendon (points to a dark curved line on MRI scan) and I’m moving forward, and as you see, some white there, we’re concerned that we’re starting to see a tear. And as we move more forward, we see more white, and then lo and behold, we start seeing a very bright white area (gestures to white patch on the MRI scan) and that’s the hole in the tendon.

(Camera moves back to Dr. Armstrong.) So for a rotator cuff repair, what we need to do is put that tendon back down onto the bone. So in a normal shoulder situation (she holds her hands up, one in a fist to represent the ball fitting under the other hand, which is curved like a socket), the tendon is attached nicely to that ball of the shoulder. So if this is the ball (rotates fist), and this is the socket (rotates curved hand), and the tendon is attached to that ball, that’s the normal situation for the tendon. (Places curved hand on top of the fist indicating how the tendon attaches to the ball of the shoulder.) But in a tear (lifts fingers to show the tendon not attached to the ball of the shoulder) the tendon pulls off. And so what we need to do is bring that tendon back down to the ball. In order to do that, we take a special little corkscrew and we screw that essentially into the bone, and then it has sutures attached to it, and those sutures we then bring up into the tendon to tie that tendon back down to the bone, so that anatomy is restored. And then that should help you with your pain.