Drugs against inflammation/NSAR
In rotator cuff rupture, traumatically caused tears, the injury itself and irritation of the tissue often lead to painful inflammation of the entire joint. This can be treated with medication. The drug group of non-steroidal anti-inflammatory drugs (NSAIDs) is a frequently used class.
It includes ibuprofen or diclofenac and many more. Unlike steroidal drugs, they do not contain hormone precursors such as cortisol. NSAIDs inhibit the production of inflammatory mediators and thus relieve pain, fever, but also the inflammatory reaction itself. The application, dosage and selection of the preparation should be determined by a physician to avoid side effects and complications.
Glucocorticoid injections under the acromion
In case of inflammation within the joint, glucocorticoids can be injected into the joint. Cortisone is the active ingredient and causes a localized, highly intensive effect through local application. The injections can be repeated, but should not be given more often than about 3 times a year. In the event of inflammation in the joint caused by a rotator cuff rupture, it should be borne in mind that cortisone can damage the tendon structure in the long term. It is often problematic that the shoulder is overloaded following glucocorticoid injections due to the strong pain relief and the pain returns after the effect has subsided.
Rotator cuff rupture – OP
Whether the rotator cuff rupture requires surgery depends on many criteria: Traumatic injuries are treated surgically as early as possible, as are athletes or people who have to work overhead. The goal of surgery is to restore the initial anatomical situation. In most cases, this is done by arthroscopy (joint endoscopy).
The surgeon uses an endoscope to look at the shoulder joint to assess the shape, size and position of the tear. Equally decisive aspects are the quality of the tendon tissue and any additional joint or concomitant damage. For reconstruction, the surgeon expands the space under the acromion by milling off small pieces of the acromion (shoulder roof) and, if necessary, removing tissue from a bursa.
The expansion prevents future mechanical irritation of the tendon. In the second step, the torn tendon is straightened and sutured to the upper arm as much as possible. Older rotator cuff tears are often treated with the mini-open technique.
The difference to arthroscopy is that the surgeon removes additional scarred tissue and roughens the bony attachment points. Then two to three metal screws are screwed into the humerus and the muscle/tendon stumps are anchored with strong sutures. In the case of very pronounced defects, a muscle transfer is sometimes necessary – in the case of additional shoulder diseases, a shoulder prosthesis may be required.
- The general condition of the patient
- The underlying cause
- The size of the rupture
- The extent of muscle atrophy
- Pain/symptoms of rotator cuff rupture
- Rotator cuffs – OP
