About Mini-Open Rotator Cuff Repair

Overview
Some rotator cuff injuries may require surgery to reattach torn tendons in the shoulder. In this procedure, sometimes called the "mini-open" rotator cuff procedure, the orthopaedic surgeon inspects the shoulder with a small camera called an arthroscope. If open surgery on the rotator cuff tendons is necessary, the surgeon reattaches the tendons to the upper arm bone, or humerus, with strong stitches.

Step 1
The initial part of the procedure may be done arthroscopically through small tubes. The orthopaedic surgeon may first use a small video camera to inspect the shoulder joint.

Step 2
The surgeon then removes any loose fragments of tendon or other debris from the damaged cuff tendon in the joint. This procedure, called debridement, helps the surgeon inspect tissue damage in the joint and determine if additional surgery is required. It is usually done arthroscopically.

Step 3
If there are bone spurs on the bottom of the acromion, the surgeon will use a rasp-like tool to smooth the area. This is called subacromial decompression, or smoothing, and will keep the acromion from pinching down on the supraspinatus tendon. It is usually done arthroscopically.

Step 4
If the surgeon finds no tear in the rotator cuff area, the procedure may end here. If the rotator cuff tendon is torn, repair is based on the size and severity of the tear. The surgeon may repair smaller tears arthroscopically, while larger tears may require an open incison of 2 - 3 inches. The torn end of the tendon is cleaned up and an area on the humerus is cleared.

Step 5
The orthopaedic surgeon puts one or more small holes in the bone. The surgeon may use a drill or other sharp tool to make the holes. Anchors are then placed in the holes. These anchors are used to hold stitches in place on the arm bone.

Step 6
The tear in the tendon is stitched together. The surgeon pulls the sutures tight to the anchors and reattaches the tendon to the humerus..

End of Procedure
The arm is usually placed in a sling after surgery. The patient will need physical therapy to regain full range of motion and increased shoulder strength. Over time, the tendon will naturally reattach itself to the humerus bone.