A torn rotator cuff is a common cause of shoulder pain among adults, which can inhibit your ability to participate in things like athletics. It can also weaken your shoulder and make everyday activities, like combing your hair or reaching into a cupboard, more difficult.
The rotator cuff is a group of four muscles that come together as tendons to hold the arm bone (humerus) into the shoulder socket (glenoid). Together, they form the rotator cuff and enable your arm to lift and rotate in different directions. When one or more of the rotator cuff tendons is torn, the tendon, or part of the tendon, no longer fully attaches to the bone. This can begin as minor fraying, turn into a partial tear, and can lead to a complete tendon tear.
In traditional open repair, the surgeon makes an incision a few inches long in the shoulder, and moves aside the shoulder muscle (deltoid) to view the torn tendon. Then the surgeon will generally remove any scar tissue or debris in the area and reattach the tendon using anchors and sutures to affix the tendon to the bone.
With an arthroscopic repair, a small video camera called an arthroscope is inserted into the shoulder through a tiny incision in the shoulder. The arthroscope displays magnified images of the shoulder joint on television monitors. The surgeon then inserts thin arthroscopic instruments, which are about the size of a pencil, through other small incisions and uses them to remove excess tissue and reattach the tendon.
In a mini-open repair, the surgeon uses arthroscopy to view the tear and treat any damage to the surrounding area within the joint. Because the surgeon does this part of the procedure arthroscopically, it avoids the need to detach the deltoid muscle. Once this is complete, the surgeon creates small incisions, about 3 to 5 cm long, and reattaches the tendon by viewing the rotator cuff area directly, rather than on the video monitor.