Question:After my rotator cuff repair, the surgeon showed me on the X-ray how much bone had to be removed. I wasn't really understanding why the bone was taken out. I thought it was just the muscle that was torn. Can you explain this?
Answer:Rotator cuff tears occur most often in young athletes and sports participants. The force of a stress greater than the strength of the muscle/tendon unit results in a tear of the tissues where the tendon joins the muscle.
The most common site of injury is the myotendinous junction. This is a region of highly folded tissue between the end of the muscle fiber and the tendon. These folds increase the surface area for force to be transmitted through the soft tissues. The junction of tendon to muscle is especially vulnerable to injury where the inflexible tendon meets the stretchy muscle.
In older adults, changes in the surrounding structures may contribute to rotator cuff tears. For example, bone spurs often form. Jagged edges rub against the tendon and cause the tissue to tear or rupture. In such cases, it's not enough to repair the torn tissue. It is necessary to remove the bone spur(s) to keep it from happening again.
In other cases, the tissue gets stuck or impinged between two moveable parts of the shoulder complex. Sometimes the surgeon has to shave the bone down or even remove the end of the bone to keep this from happening.
When you see your surgeon again, don't hesitate to ask him or her to explain again what happened in your case. The more you can understand about your own injury and recovery, the better. Preventing rerupture or other injuries from happening is an important part of patient education.Hiroyuki Sugaya, MD, et al. Repair Integrity and Functional Outcome After Arthroscopic Double-Row Rotator Cuff Repair. In Journal of Bone and Joint Surgery. May 2007. Vol. 89-A. No. 5. Pp. 953-960.
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