Rotator cuff surgery for the supraspinatus muscle

Rotator cuff surgery for the supraspinatus muscle.
Arthroscopic treatment of rotator cuff disease initially consisted of rotator cuff inspection and debridement and arthroscopic acromioplasty. If a repairable rotator cuff tear was discovered, an open or miniopen repair of the tendon was then performed. As surgeons’ skills improved and more specialised instrumentation was developed, it became possible to fix relatively small tears by using arthroscopic techniques to insert anchors, pass sutures, and tie knots. In current practice, surgeons can use these arthroscopic techniques in the shoulder to repair even large rotator cuff tears.
An overly aggressive acromioplasty must be avoided because excessive removal of the anterior acromion can result in the humeral head sliding forward, up, and out of the socket (anterosuperior subluxation).
The rotator cuff tear is then visualized through the lateral (side) portal from the “50-yard-line view.” The size and pattern of the tear are assessed. Any thin or fragmented portions are removed, and the area where the tendon will be reattached to the bone is lightly debrided to encourage new blood vessel ingrowth for healing.
The sutures are once again passed through the tendon and systematically tied. The sutures pull the tendon down to the prepared bone surface, closing the defect. This completes the repair.