Tears of the Rotator Cuff Part 3: Suture Anchor Repair of the Rotator Cuff 

Awesome!

Glad you found it helpful!

Thanks for reaching out. Good luck with your surgery!

Thanks so much for the feedback. Hopefully, I can continue to find time to add content!

Thanks for watching!

I am glad you found it helpful.

I don't have a video on that at the moment. It would be a good topic to cover at some point. Any other suggestions for topics?

Thanks for the question. The chance of an anchor pulling out is very low. I have only seen it happen after a patient actually fell onto the shoulder right after surgery!

Thanks for the question. The sutures are pretty small and don't really affect the tendon. I suppose you could put a LOT of sutures through the tendon and that could cause a problem. During surgery we use enough to hold the tendon securely without overdoing it. The bigger issue can actually be room on the bone for the actual anchors to "anchor". There is only so much real estate and you have to be strategic when deciding the best location for fixation and counter-acting the forces across the tendon. Anchors sizes can vary depending on the needs of the surgery, quality of the bone etc.

Good question. You have to be careful and have a steady hand!

Thanks for your question. Good question. The repair sutures hold the tendon in place until the tissue heals back to bone. This takes time which is why we use a sling after surgery and have restrictions regarding activity. After enough time has passed, the strength of the tendon where it has healed to bone will tolerate the load through the shoulder.

​@@JeffreyWittyMD I have same tear . Not sure how many anchors he is going to use. I'm afraid to ask .

This is an important question. The answer is that "it depends". Smaller / incomplete tears may not get bigger in size. However, larger tears can indeed get bigger with time. If the tears get bigger the tendon may retract further from the attachment site on the humerus. The muscle attached to the tendon can also atrophy over time as well. A detailed review of your MRI with an ortho surgeon can help you understand your particular injury. _______________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure. All patients have been consented for use of any imaging, video, or other media.

Good question, We use the awl because it compacts the bone (instead of removing bone) around the pilot hole which allows for better purchase of the anchor into the bone.

@@JeffreyWittyMD OK. Makes sense. The bone walls are denser than normal. Thanks

Thanks for the question. I usually quote about 6 months of time before people are fully released for unrestricted activity. Keep in mind that each injury is unique and every patient is different and they may take different amounts of time to get back to their desired activity. In general, I use a sling for 6 weeks after surgery, strengthening at 12 weeks after surgery and then about 6 months I am looking to see if people are ready to be fully released. Also, different patients have different activity demands (think an athlete vs sedentary person). This will potentially add the time it takes to develop the strength and skill that particular sport/activity/work requires. ___________________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.

@@JeffreyWittyMD would you recommend this surgery for a 76 year old man ?

The first week after shoulder surgery can definitely be tough! Things should keep getting better each week. Just take it a day at a time. Hang in there and good luck!