Dr. Patrick J. Denard explains why arthroscopic rotator cuff repair beats open surgery. The approach uses a small incision and camera for better visualization and anatomy. It cuts infection risk to 1 in several thousand and gets patients back to normal faster with less pain.
Hi, I'm Patrick Denard and I'm here with you today discussing my blog on arthroscopic solutions for rotator cuff repair. It's interesting, the advent of arthroscopy for rotator cuff repair kind of parallels the advent of cell phones. You know, if you think back to the 1980s, there was a few people running around with these big huge cell phones and you saw it on Miami Vice perhaps. And at that time there was a few people doing arthroscopy. And then this really took off in the 1990s and early 2000s to where we are today. Much like where we are today with cell phones, we've gone from big huge satellite phones to flip phones and now these smartphones that everybody has. And you kind of ask yourself if somebody doesn't have a smartphone, hey, that's kind of weird. The same goes with arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair really provides you the best solution to repair the rotator cuff. Interestingly though, there's still about 20% of rotator cuff repairs done in the United States are done in an open fashion. And that's unfortunate because there's really 3 major advantages of arthroscopic rotator cuff repair. The first is better visualization. With an arthroscopic approach, you make a small little stab incision in the shoulder and then you can look in all around. You can move the camera around and really see the tear for what it is. You can really appreciate the anatomy and then the appreciation of that anatomy leads to a more anatomic repair subsequently and we think that's going to provide somebody with a better outcome in the long term. The second thing is that with an arthroscopic approach there's a lower complication rate. You can imagine when we make a big incision on the side of the shoulder and the front of the shoulder, we have a higher rate of infection. Okay, so the infection rate is much higher with an open approach compared to an arthroscopic approach. With an arthroscopic approach it's actually 1 in several thousand in some studies. And the other factor with that is that with an arthroscopic approach, you have less chance of getting stiffness after the operation because you're making just these little small stab incisions rather than making this big incision that must heal. And sometimes that heals in a disorganized manner and somebody gets stiffness after their operation. The third and final thing is recovery, and that's really important for the patient. I think the, the factor of visualization, getting it repaired right, is number one, but then number two is recovery. Because the arthroscopic repair is just done through little stab incisions. It leads to less invasion, and we know that intuitively, but that's also been shown in basic science studies as well, that when you make smaller incisions in the shoulder, that leads to less inflammation and consequently less pain. I've had the opportunity to see people who have previously had an open repair done years ago and then come to me for another repair on their opposite shoulder. We've done that arthroscopically and they remark what a difference it is in their recovery in terms of pain, which is a big factor in getting back to your quality of life. So the 3 factors again that are important for, or advantage of arthroscopic rotator cuff repair are better visualization, a lower complication rate, and an easier recovery. So for more information, see my blog or visit us on our website at www.OregonShoulder.com. Thanks.
