Non-reparable Rotator Cuff Tears

The rotator cuff is a group of four muscles and tendons that cover and support the movement of the shoulder joint. Tears in the rotator cuff can cause pain and disability, but can usually be treated with conservative or surgical methods. Tears of the rotator cuff that do not heal with these methods are considered non-reparable rotator cuff tears.

Signs and symptoms that may indicate a non-reparable tear are prolonged duration of weakness when you rotate your arm, narrowing of the space between the bony prominence of the scapula (shoulder blade) and the humerus (upper arm bone), infiltration of fatty tissue within the rotator cuff musculature, and retraction of the tendon from its attachment.

When you visit the clinic with persistent shoulder pain, your doctor will review your history and order CT or MRI scans to confirm on the diagnosis.

Treatment options for non-repairable rotator cuff tears may include:

  • Non-operative treatment: Physical therapy to improve the strength and range of muscles that surround the shoulder and steroid injections to bring down swelling and pain
  • Arthroscopic procedures: Debridement or removal of damaged tissue from the joint, releasing the damaged or inflamed biceps tendon from its attachment at the shoulder, partial repair of tissue where possible, suprascapular nerve release if the rotator cuff tear is pulling on the nerve causing painful symptoms
  • Muscle transfer: Transfer of the muscle of the back (latissimus dorsi) or chest (pectoralis major) to repair the torn rotator cuff
  • Hemiarthroplasty: Replacement of the humeral head with an artificial prosthesis, indicated in cases of arthritis of the shoulder, when you are still able to raise your arm.
  • Reverse total shoulder arthroplasty: Replacement of the shoulder ball and socket joint and interchanging the prosthesis to have the metal ball prosthesis attached to the shoulder blade and plastic socket to the humerus. This technique is used in severe cases where the arm is almost paralyzed due to pain and you are unable to lift the arm.
  • Co-relating the correct treatment option to your condition is critical in ensuring the best possible surgical outcome.