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Rotator Cuff

03/06/2015

ROTATOR CUFF Shoulder Surgery available in France


 

The rotator cuff is a group of four muscles (and their tendons) that are positioned around the shoulder connecting the upper arm (humerus) to the shoulder blade (scapula). They work together to help us with shoulder movement and stabilisation.

The four muscles are:

  • Teres minor

  • Infraspinatus

  • Supraspinatus

  • Subscapularis


Each muscle is inserted into shoulder blade and has a tendon that attaches to the upper arm and together they form a ‘cuff’ around the upper arm.

This part of the body can often become damaged and inflamed due to injury, exercise, or general wear and tear over the years. The common name for this type of injury is Rotator Cuff Injury for which there are a number of treatments depending on the specific diagnosis.

Injuries are typical of the falls on the stump or shoulder movements of abduction thwarted. These fractures involve the supraspinatus, the most often, but you can see breaks in the entire external rotator cuff: supraspinatus, the infraspinatus and teres minor.

Arthroscopic repair of the tendons of the rotator cuff

When repair of the rotator cuff is decided several operations will succeed:
1. Exploration of the joint: This exploration enables to confirm the lesions found with imaging tests (theMRI may well underestimate tendon lesions)


Also look for the presence of osteoarthritis (cartilage wear) whose presence may explain part of pre-operative pain but also residual pain after an operation on the tendons.

The biceps (also frequent source of pain) will be evaluated.

The exploration will also include the space under acromial, often seat of intense inflammation (bursitis), looking lesions of the superficial surface of the tendons, of the aggressive nature of the acromion and the underside of the joint acromioclavicular.

2. Surgical procedures:
The cleaning of the space under acromial is necessary to remove the thick, inflammatory and painful tissue, but also to see the top side of the tendons.


Usually we practice acromioplasty to make the bone ceiling mild (nonagressive), the most common resection of the coracoacromial ligament (which extends the acromion forward and contributes significantly to the tendon conflict).
Some surgeons (including the ones we are working with) will performe a gesture on the long biceps, which will simply be cut (tenotomy of the biceps) or reinserted to the humerus bone in or under the eaves (biceps tenodesis).


Finally the acromioclavicular joint may be the place of intense inflammation also, often as part of early osteoarthritis, because of aggressive parrot beaks in contact with the tendons of the rotator. It is therefore the subject of minimum planing (co-planning) or even of a radical resection treatment of the last centimeter of the clavicle (removal of the diseased articulation).






Advantages of the arthroscopy:



 The arthroscopic exploration permits an almost complete view of the joint, a comprehensive assessment of tendon injuries.
It allows to repair all types of tendon rupture.

The approach of the tendons is minimally invasive and does not require muscle avulsion, alleviating the immediate aftermath and sometimes the type of asset.






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