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The rotator cuff can cause pain in many different ways including tendonitis, bursitis, calcific tendonitis, partial thickness tears, full thickness tears or mechanical impingement. [5] Tendinitis, bursitis, and impingement syndrome can be treated with tendon repair and the Mumford procedure or acromioplasty. [citation needed]
National joint registries have reported 10-year survivorship for the diagnosis of rotator cuff arthropathy of 94.1%. Increasing surgeon experience with the reverse prosthesis has seen a decrease in complications and a change in the indications for surgery. An early expanded indication was primary osteoarthritis with loss of rotator cuff function.
However, partial rotator-cuff tears may also demonstrate good pain relief, so a positive response cannot rule out a partial rotator-cuff tear. However, with demonstration of good, pain-free function, the treatment will not change, so the test is useful in helping to avoid overtesting or performing unnecessary surgery.
In tendinitis of the shoulder, the rotator cuff and/or biceps tendon become inflamed, usually as a result of being pinched by surrounding structures. The injury may vary from mild inflammation to involvement of most of the rotator cuff. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion.
The rotator cuff compresses the glenohumeral joint during abduction of the arm, an action known as concavity compression, in order to allow the large deltoid muscle to further elevate the arm. In other words, without the rotator cuff, the humeral head would ride up partially out of the glenoid fossa, lessening the efficiency of the deltoid muscle.
With good outcome in rotator cuff arthropathy, the indications for performing reverse shoulder arthroplasty has also expanded to all the situations where the rotator cuff function will be compromised such as unreconstructible fractures of proximal humerus, fracture sequelae, revision shoulder arthroplasty, shoulder instability along with ...
Surgery may be done arthroscopically or as open surgery. The impinging structures may be removed in surgery, and the subacromial space may be widened by resection of the distal clavicle and excision of osteophytes on the under-surface of the acromioclavicular joint. [4] Damaged rotator cuff muscles can be surgically repaired.
They may be caused by strength imbalance of the rotator cuff muscles. People with dislocated shoulders typically present holding their arm internally rotated and adducted, and exhibiting flattening of the anterior shoulder with a prominent coracoid process. [citation needed]