What are Rotator Cuff Tendons?
Rotator Cuff is a term which refers to four tendons that pass through the sub-acromial space of the shoulder. Each component tendon has its own name:
- Teres Minor
They are collectively called “The Rotator Cuff”. They blend into a hood-like structure that that is attached to the front, top and back of the head of the humerus. The direction that the head of the humerus moves within the shoulder joint socket is determined by which component of the rotator cuff is pulling the most. They, along with the bursa that lines their upper surface, pass backwards and forwards through the small space between the head of the humerus and acromion. This is called the Sub-Acromial Space. The rotator cuff tendons may be subject to irritation or catching due to injury or overuse as they pass through the sub-acromial space. The sub-acromial space can also be crowded due to the natural shape of the acromion or the development of an acromial spur. These scenarios are termed rotator cuff or Shoulder Impingement.
What is Rotator Cuff Decompression?
Patients with shoulder impingement symptoms that fail to respond to non-surgical treatment over a period of time may need to consider a surgical solution. The surgery required is commonly called Rotator Cuff Decompression. However the same procedure is also commonly referred to as Sub-Acromial Decompression or Acromioplasty. All of these terms have a similar meaning.
How is Rotator Cuff Decompression Performed?
Rotator cuff decompression can be achieved using one of 2 techniques:
- Open Rotator Cuff Decompression
- Arthroscopic Rotator Cuff Decompression
The principle goal of either technique is to establish a larger space for the rotator cuff tendons and sub-acromial bursa to pass under the acromion without impingement. Although an arthoscopic procedure may seem more attractive in terms of smaller surgical incisions, there may be particular circumstances about your shoulder impingement where a slightly larger incision is preferred. If there is no evidence of significant rotator cuff tearing Mr Lyons will generally advise an arthroscopic surgery. However if the shoulder impingement is complicated by full thickness tearing Mr Lyons will discuss the case for an open rotator cuff decompression and secure repair of the torn rotator cuff. Regardless of technique the ultimate goal is the same – return of the best possible shoulder comfort and function.
The decompression is achieved by reshaping the front edge and under surface of the acromion. This establishes a larger space for the rotator cuff tendons to pass through. A tight band of tissue that bridges over the tendons called the Coraco-Acromial Ligament is also released to take pressure off the rotor cuff. Thickened parts of the sub-acromial bursa are removed. It will reconstitute with normal thickness during the recovery process. Any tearing of the rotator cuff will also be addressed. Following surgery Mr Lyons will guide you through the rehabilitation process.