Rotator cuff tear

Question 1

What is a rotator cuff tear?

Answer 1

A tear in the tendon that attaches to the rotator cuff muscles. Most likely to be supraspinatous.

Question 2

How does a rotator cuff tear occur?

Answer 2

Many occur with no/little trauma due to degenerative processes on the tendons. Classic history is sudden jerk in patients over 40.

Question 3

Types of tear

Answer 3

Could be partial or full thickness.
A tear in the supraspinous will present as difficulty abducting.
A tear in the subscapularis will present as difficulty internally rotatating
A tear in the infraspinatous will present as difficulty externally rotating.

Question 4

Investigations into RCT

Answer 4

Ultrasound or MRI allows you to see the tear.

Question 5

Treatment of rotator cuff tears

Answer 5

Surgery- rotator cuff repair with subacromial decompression. Performed to improve/maintain strength however fails in a 1//3rd of patients.
Non-operative- physiotherapy can strengthen the other rotator cuff muscles