Pearls and pitfalls: Arthroscopic rotator cuff repair

By Robert M. Titelman, MD

The goal of any arthroscopic surgical procedure is to reproduce what is done with its corresponding open procedure. Sometimes this simple tenet can be forgotten as we try to perform procedures in a minimally invasive manner. If the patient’s anatomy has not been adequately restored, however, the goal has not been attained, no matter how small the incision.

Generally, surgical procedures tend to be more effective if they restore or reproduce the anatomy of the joint as it was prior to the disease process. This is also true of rotator cuff repair. Success rates in rotator cuff surgeries are higher in patients with intact repairs. Recent studies with magnetic resonance imaging (MRI) or ultrasound have shown arthroscopic repairs to be intact 83 percent of the time at 1 year. Even though patients may get relief without an intact repair, the primary objective is to heal the rotator cuff repair. To optimize healing of the repair, the surgeon should address two major areas of the repair—stability and protection.

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