Question:The results of my MRI came back with the report that I have a massive rotator cuff tear. What does that mean and what happens next?
Answer:Your surgeon will probably review the report with you and give you more specific and accurate details. A massive tear of the rotator cuff tendons around the shoulder usually means there are at least two tendons torn. And the tears are significant in size (length and/or width).
There are many ways to treat a rotator cuff tear (RCT). The surgeon may form a preliminary decision based on your clinical exam and the results of MRIs. Once inside the shoulder, then the location, shape, and size of the tear guide what type of surgery is needed.
Small tears can be treated with debridement. The surgeon removes any frayed edges or free floating pieces that may have torn off completely. The edges are smoothed down in hopes that they will reattach or re-adhere to an area close by. This type of procedure is called debridement.
For larger tears, a partial or complete repair is done. The joint capsule and some of the ligaments around the joint may be cut or released. This allows the surgeon to rebalance the shoulder where it belongs. Mobility is improved and tested in the operating room. Then the surgeon uses sutures to hold it in place until everything heals again.
It's likely you'll be seeing a physical therapist for instructions and a rehab program. The exercises and timing of the program are determined by the type of tear and repair you have done. You can expect a three month period of rehab. This will be followed by some life-long activities and exercises needed to keep a healthy shoulder.Michael Moser, MD, et al. Functional Outcome of Surgically Treated Massive Rotator Cuff Tears: A Comparison of Complete Repair, Partial Repair, and Debridement. In Orthopedics. June 2007. Vol. 30. No. 6. Pp. 479-482.
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