20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

ROTATOR CUFF INJURIES

The rotator cuff is a structure composed of four muscle-tendon units. The four muscle-tendon units are the supraspinatus, infraspinatus, subscapularis, and teres minor. The most important function of the rotator cuff is to keep the proximal humerus (ball) well-positioned within the glenoid (socket). A secondary role of the rotator cuff is to provide one the ability to elevate, raise and rotate his/her arm and shoulder.

Rotator cuff injuries are relatively common. There are three distinct types of rotator cuff injuries:

  • Bursitis/Impingement
  • Tendinitis
  • Tear (partial-thickness or full-thickness)

Bursitis/impingement implies that the fat tissue sac above the rotator cuff is inflamed. Bursitis can occur with overuse of the shoulder or in patients who have irritated the rotator cuff tendons. Tendinitis implies that the tendon(s) of the rotator cuff are inflamed, but not torn. Tendinitis is common in patients with overuse injuries, such as in patients who play certain sports or in laborers. A tear of the rotator cuff may occur from a lifting injury, a fall on the shoulder, or with chronic wear and tear.

Symptoms

  • Sharp shoulder pain with overhead activity
  • Shoulder pain when sleeping
  • Weakness with shoulder use

Diagnosis And Treatment

Dr. Keller considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis of rotator cuff injury. Dr. Keller usually orders an MRI or ultrasound to confirm the diagnosis and evaluate the injury type and/or tear pattern. Most patients with tendinitis, bursitis, and partial thickness tears can be treated successfully without surgery. Treatment options include a physical therapy program, oral analgesics, as well as targeted injections (for example, steroid injections).

In those patients with full thickness rotator cuff tears or those with bursitis who fail non-surgical management, Dr. Keller may recommend surgery. Surgery is minimally invasive; Dr. Keller uses an arthroscope (surgical camera) and surgical instruments to remove the inflamed bursa, and if necessary, repair the torn rotator cuff.