New rotator cuff surgery done on out-patient basis

LAURIUM – Rotator cuff surgery is not only for professional athletes, and a new procedure being used at Aspirus Keweenaw Hospital is intended to reduce the time for surgery and reduce the chance of failure of the repair for patients.

The rotator cuff is comprised of a group of muscles and tendons which stabilize the shoulder.

Aspirus Keweenaw orthopedic surgeon Dr. Frederick Rau said the traditional method of rotator cuff surgery to reattach a torn tendon to the shoulder bone where it meets the top of the humerus bone used narrow sutures, which required tying off with knots. The procedure took a significant amount of time, which could lead to swelling of tissues, slowing the process even more. The sutures also would sometimes tear through the tendon under use, requiring another surgery.

Rau said the traditional method of repairing the torn tendon required cutting open the flesh over the shoulder, moving the deltoid muscle, then scraping the shoulder bone to create an place to anchor the sutures.

“The problem is, how do you get a stitch to hold to a bone?” he said. “You have to have healthy bleeding bone for it to anchor.”

There are four to six rotator cuff surgeries performed each month at Aspirus Keweenaw, Rau said, and he’s performed four surgeries with the new method since February.

Rau said the new knotless surgery is an arthroscopic procedure, which requires only a few small incisions through which a small camera and surgical devices are passed. The doctor performs the procedure watching a television screen.

The procedure involves creating a hole in the bone into which anchors are placed. Fiber tape, which replaces the much more narrow sutures, is secured in the anchor then passed through an incision in the damaged tendon. The pieces cross each other forming an X from four anchor points.

“It’s like you’re tying down a tarp,” he said.

The anchors used for the knotless tape method of rotator cuff surgery eventually are absorbed by the body, Rau said.

The traditional method of cutting into the shoulder would take about two hours to complete, Rau said, and the patient would have to stay in the hospital overnight to recover. The new fiber tape method takes about one hour and is done on an out-patient basis.

“The patient leaves the operating room with less swelling,” he said.