Rotator Cuff Arthropathy Treatment Options
What are the treatment options for rotator cuff arthropathy?
Nonoperative treatment, arthroscopic debridement with a biceps tenodesis or tenotomy, complete or partial repair, patch augmentation, superior capsular reconstruction, muscle/tendon transfers and reverse should arthroplasty.
- Nonoperative treatment involves activity modification, steroid injections, and physical therapy. This is first line treatment for patients with minimal symptoms.
- Arthroscopic debridement is a minimally invasive procedure to remove loose pieces of tendon tissue, cartilage fragments and bone to improve pain and rotator cuff function. This may be combined with surgical repair of the torn tendon called biceps tenodesis or tenotomy.
- Biceps Tenodesis is major surgery performed under general anesthesia. When performed due to arthropathy, it will often be an open procedure.
- Tendon transfer may be needed where torn tendon is so damaged that it can’t be reattached. A nearby tendon may be used as the replacement. This procedure is an option for young, active patients with irreparable cuff tears.
- Complete and partial tear repair is generally unsuccessful with massive degenerative tears due to the high re-tear rate. However, if Dr. Godin determines that a complete repair is possible, he may recommend the patch augmentation using grafted tissue.
- Superior capsular reconstruction is a treatment for massive irreparable rotator cuff tears. This is an anatomic reconstruction of the shoulder capsule to restore normal restraints to the deficient rotator cuff. It is only available for patients without severe arthritis.
- Hemiarthroplasty is a partial shoulder replacement where the head of the upper arm bone is replaced with a prosthesis. It is indicated for patients with shoulder joint arthritis when the socket bone is inadequate for a total shoulder replacement.
- Reverse Shoulder – Reverse shoulder replacement is the gold standard procedure for massive cuff injuries that cannot be repaired in older patients with symptomatic rotator cuff arthropathy who are somewhat inactive. It is the preferred treatment for reliable improvements in pain and function. Here the rotator cuff muscles no longer function correctly and are too damaged or atrophied to be repaired. Since there is no cuff to support the arm and provide function, Dr. Godin will use the deltoid muscle instead, to provide strength and power to move the shoulder joint. This procedure is indicated for patients with progressive pain and deterioration of shoulder function.
Dr. Godin has an array of surgical options both established and emerging techniques. He is a world-class surgeon and a leader in sports medicine. Trained at the renowned Steadman Clinic in Vail Colorado, he is fellowship trained in advanced arthroscopic and reconstructive surgical techniques for the treatment of complex orthopedic and sports related injuries. Contact him at his Vail, Frisco, or Edwards Colorado office to schedule a consultation to receive the correct diagnosis and all your treatment options.