The rotator cuff is the motor of the shoulder. It consists of 3 main tendons and 2 additional tendons.
The task of the rotator cuff is to hold the ball in the socket during shoulder movements and thus provide a certain degree of stability when force is applied.
Rotator cuff tears usually affect one or two main tendons and, in rare cases, all three.
The tearing of the tendons is rarely an accident, but is usually caused by a constricted subacromial space (see “impingement”) leading to chafing of the tendons.
The long biceps tendon, which runs through the shoulder joint, plays a special role here and can be a promoter of rotator cuff rupture in the event of instability.
Dislocation of the shoulder from the age of 40 can lead to a tear in the rotator cuff. An ultrasound examination of the shoulder usually reveals this emergency immediately.
The method of choice for rotator cuff rupture is surgery. Even partial tears or small tears have the risk of becoming large tears in 2-5 years.
Actually always! Because small tears become larger and painful/functionally restricted shoulders are an indication of an unstable tear situation with growing tears.
The methods are varied, from minimally invasive athroscopic complete suturing to mini-open reconstruction or partial reconstruction through to muscle transfer in younger patients, the range of options is very broad. In isolated cases, a new shoulder joint is also the method of choice. The choice of method depends on the muscle and tendon situation of the rotator cuff, which is clarified in an MRI examination.
Dr. Martin Schwarz, MSc, Prim. a.D.
Specialist for trauma surgery,
Specialist in Orthopedics and Traumatology Shoulder Center Vienna
Surgery for shoulder, knee and sports injuries