Graft Augmentation of a Massive Rotator Cuff Tear

The rotator cuff is a group of four muscles that run from the scapula (shoulder blade) and attach to the humeral head (top of upper arm bone) by their tendons. When the rotator cuff is torn and left untreated for an extended period of time, the tendon retracts away from its attachment point and the muscle atrophies and degenerates (shrinks, weakens, and irreversibly turns to useless fat and scar tissue). This makes the repair technically more difficult and in some cases impossible. In these cases, an alternative method of repair is utilized. When one of the rotator cuff tendons is largely retracted and unrepairable, surgery using an extra portion of the biceps tendon, dermal allograft, or Iliotibial band to reinforce the rotator cuff repair is indicated.

Dr. Chudik approaches rotator cuff tears arthroscopically through small incisions (arthroscopic portals). The surgery is generally performed as outpatient surgery (you go home the same day). Dr. Chudik uses the small incisions to look in the shoulder joint with a camera and special instruments are used to identify, release, mobilize and repair as much of the rotator cuff as possible. If a large portion of the rotator cuff cannot be repaired, there are a few techniques practiced. Dr. Chudik developed and published an arthroscopic method to reinforce the rotator cuff repair site with an extra portion of the biceps tendon, dermal allograft or iliotibial band to reconstruct (re-make) the rotator cuff tendon or make it thicker, more robust and less likely to fail.

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