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Reconstructive Orthopedics – Rotator Cuff Overview

Brad Bernardini, M.D., John Gray, M.D., and Jeffrey Murray, D.O., M.S.P.T., discuss how the rotator cuff can sustain an injury as well as the approaches they take to help repair rotator cuff injuries.

Please see below for the full video transcript.

Dr. Gray: The rotator cuff is a group of four muscles that surround the shoulder. It is the natural aging process of the rotator cuff to begin to tear, or fray, or begin to fail as we get older.

Dr. Murray: The younger population, if they're gonna tear their rotator cuff, usually it's a more of a traumatic event where they had a pulling type injury to the shoulder and end up with a rotator cuff tear from that.

Dr. Bernardini: Younger patients with an acute injury, we found that relatively early repairs are most successful. So, we do like to be a little bit more aggressive with those patients.

Dr. Murray: The ultimate goal of any rotator cuff repair is to have a patient return to full prior levels of function. Usually, patients are in a sling for up to six weeks after surgery. You are starting physical therapy during that six-week time with just some gentle range of motion, then progressing to strengthening as the rotator cuff heals. Ultimately, it can take up to six months or longer to heal from a rotator cuff repair.

Dr. Bernardini: Older or elderly patients with a degenerative rotator cuff tear, we found do really well with nonoperative treatment. A lot of those patients are gonna have a return to near normal function, very minimal pain, and an ability to have a good quality of life without surgery. Because we know a lot of those tears may be asymptomatic or long-term, we want to try to be conservative with those. So, physical therapy, rarely injections, activity modification for a short time before the full function and compensation can take over.

Dr. Gray: Our motto is, basically, let's try the most conservative approach first. If indeed it does ultimately require surgery, we do feel that we've got all the highest level of surgeons to get people back to the best results and to the activities they are interested in doing.

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