Open Rotator Cuff Surgery: A Case Study in Orthopedic Medicine
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The shoulder joint is a ball and socket joint. It enjoys the most freedom of movement of any joint in the human body. The humeral head (ball) fits into the socket of the glenoid cavity (socket). The cavity is less concave than most sockets in ball and socket joints, which allows for increased freedom of movement. This permits flexion, abduction, circumduction, and rotation. At the same time, the joint is anatomically less stable and must be stabilized in some manner. The rotator cuff is a series of tendons and tnuscles which stabilize the joint by keeping the humeral head firmly intact in the shoulder cavity. These tendons allow for flexibility and freedom of movement of the shoulder. The increased range of motion leaves the tendons susceptible to injury and is the source of many associated problems of the shoulder. Tendonitis is the most common shoulder problem that is associated with the rotator cuff. Tendonitis is simply an inflammation of the rotator cuff tendons and is most often caused by overuse at work or some activity where the rotator cuff is repeatedly stressed. It can also be caused by impingement, which is a pinching of the tendon between the head of the humerus and the overlying acromion. Tendonitis can be treated using anti-inflammatory medication and physical therapy. The most debilitating injury associated with the rotator cuff is the tearing of a rotator cuff tendon. This injury predominately occurs in patients over the age of 30, as tendons become less lax and are more susceptible to tearing. This injury primarily occurs during jerking or lifting motions or falling. Slow deterioration of the rotator cuff tendon resulting from prolonged tendonitis and impingement can also cause the tendon to easily tear. Open surgery to repair the tendon is the only treatment that results in recovery to previous functioning levels.