Surgery for the shoulder is indicated when the patient has pain in the shoulder that originates from the shoulder, not from the neck, and has not been relieved with conservative or non-surgical treatment. Rotator cuff repair is one type of surgery performed for shoulder pain. Rotator cuff repair should be considered when there is a complete tear, or near complete tear of the rotator cuff tendon or tendons. Partial tears (fraying or degeneration) of the tendon can be improved without surgery in most instances. Studies have shown that most rotator cuff tears are progressive. Overtime the tears become larger and the affected muscles become weaker and atrophy (wither away). Once muscles and tendon have atrophied, treatment options are limited.
The basic principle of rotator cuff surgery is to reattach the torn muscle-tendon complex to the humerus. In addition to the repair other abnormalities or pathologies within the shoulder are corrected. There are several different ways to accomplish this and the best way is the procedure that gives an inpidual surgeon their best results.
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Shoulder instability is most commonly exhibited by recurrent anterior dislocation. Anterior shoulder instability can be corrected arthroscopically by shrinking or tightening the capsule or by an open procedure. The most common open procedure, Bankart anterior reconstruction, involves cutting and reattaching the anterior capsule and ligaments to the glenoid. The open procedure is successful over 95% of the time. The arthroscopic procedure is less invasive but also less successful. Both methods are acceptable treatments.