Less Invasive Shoulder Surgery
To minimize this risk, surgeons began performing "mini-open" rotator cuff repairs. Rather than detaching the deltoid muscle, surgeons now literally split the muscle fibers to gain access to the rotator cuff. The mini-open repair has become the gold standard approach to rotator cuff surgery. Recent studies show that there is significantly less atrophy or "shrinkage" of the deltoid muscle if the muscle is split rather than detached. Over the last 15 years, surgeons have studied the effects of an even less invasive approach to the rotator cuff: through the arthroscope.
An arthroscope is a small camera that is introduced into a joint through tiny incisions, usually measuring less than a centimeter. The camera allows a surgeon to visually inspect very small spaces that are otherwise difficult to access through "open" surgery. The arthroscope has been used to facilitate surgery in the shoulder for decades, but with recent advances, surgeons are now able to use the arthroscope do an entire rotator cuff repair surgery.
When the rotator cuff is repaired arthroscopically, there may be less surgical stretching and damage to the deltoid muscle. This may reduce pain after surgery, making rehabilitation more tolerable. The total time to recovery is likely no different when the arthroscope is used, but the early post-operative course may be easier.
Early data indicated that the arthroscopic technique resulted in a high re-tear rate of the rotator cuff, but as the technique has been refined, more recent data suggest that arthroscopic repairs provide a durable repair with excellent pain relief. At Saint Louis-Clayton Orthopedic Group, the surgeons have training and expertise in both mini-open and arthroscopic techniques.
To read more about rotator cuff problems, click here.
