Rotator Cuff Repair: How Advanced Techniques Have Changed Shoulder Surgery

How has rotator cuff repair evolved?

Rotator cuff repair and orthopedic surgery, as a practice, now go beyond traditional open surgery. While effective, this method severely disrupted muscle tissue and caused additional blood loss with a higher risk of complications. For decades, patients have had the option of open or minimally invasive surgery (MIS), which reduces many of these concerns. MIS uses small incisions and arthroscopy to view and diagnose orthopedic issues. Additional small incisions allow small surgical tools to repair the injury or damage. This advanced technique allowed patients to experience smaller scars, less blood loss, reduced infections, and less postoperative pain. Now, there are more cutting-edge strategies that make rotator cuff repair more efficient and effective.

Arthroscopic double-row repair

Large or complex rotator cuff tears can still benefit from arthroscopic repair thanks to the double-row technique. The surgeon uses 2 rows of anchors to reattach the torn tendon back to the bone. By using anchors in the medial and lateral locations, the rotator cuff returns to the exact anatomical position. The double-row technique exceeds the traditional single-row by improving tendon-to-bone contact while optimizing healing. Studies also show lower rates of retearing and improved rotator cuff function over time.

Using grafts to improve outcomes

Surgeons have long used grafts for ligament damage of the knee and elbow. For severe rotator cuff tears, surgeons can use biologic augmentation with grafts to accelerate the healing process. This strategy involves creating a graft from the patient’s tissue or a donor to reinforce the rotator cuff. Some grafts are made of synthetic materials like polypropylene. The tissue or graft acts like a scaffold, reinforcing the surgery and reducing the risk of retears. Grafts can sometimes contain stem cells to further assist with healing. This advanced technique aims for better outcomes and synergy with surrounding tissue.

Combining surgery with regenerative medicine

Shoulder surgery is only successful if there is optimal healing and recovery. Now, surgeons are combining arthroscopic shoulder surgery with regenerative medicine to improve healing and function. Platelet-rich plasma (PRP) and mesenchymal stem cell (MSC) injections are being used to accelerate tendon healing. These strategies take the body’s natural healing factors from the blood or bone marrow to inject into the shoulder after surgery. Multiple sessions can reduce inflammation and help with tissue regeneration.

Bring in the robots

Technology in the form of robotic-arm-assisted surgery helps with precision and success rates. Surgeons perform the procedure behind a console while using peripherals to control a robotic arm. The arm performs incisions and the necessary repairs. Before surgery, computer-assisted programs can help determine the best course of action for shoulder repair. This technique is particularly useful in total shoulder replacement for patients with severe arthritis. As more surgical centers adopt robotics, these devices and applications are quickly becoming a part of the surgical process.

Enjoy improved shoulder surgery outcomes

Rotator cuff repair and other shoulder surgeries are often necessary to address damaged tendons or even replace joints. Gone are the days of traditional surgery. Along with MIS, there are techniques surgeons can use to improve speed, accuracy, and success rates. The future of orthopedic surgery continues to evolve, with ongoing research into gene therapy, biomaterials, and artificial intelligence. If shoulder surgery is on the horizon, work with the surgical team to benefit from the many innovations available today.