What is the Rotation Medical Rotator Cuff System?
The Rotation Medical rotator cuff system is a novel technology employed in the treatment of rotator cuff disease. It involves the placement of a bioinductive tissue implant in the diseased rotator cuff area of the shoulder to induce new tissue growth with histological characteristics of a rotator cuff tendon.
The bioinductive tissue implant is obtained from a bovine Achilles tendon and goes through special chemical processes, designed to enable blood vessels to infiltrate. Enhanced tendon strength is accomplished as a result of induced, remodeled tissue. The tissue implant gradually becomes absorbed, leaving a fresh layer of tendon tissue to supplement the existing rotator tendon tissue.
Rotator cuff disease is defined as an injury or damage to the rotator cuff as a result of a trauma, fall, overuse, inflammatory conditions such as arthritis, degeneration, and aging. Rotator cuff damage is one of the most common reasons for shoulder pain. Standard approaches for treating a torn or degenerated rotator cuff often have not addressed the below-par quality of the underlying tendon tissue, and a notable number of these tendons, after traditional treatment, have either re-torn and/or degenerated further.
The goal of the Rotation Medical rotator cuff system is to prevent the progression of the rotator cuff disease and decrease the chances of re-tears by promoting the growth of fresh tendinous tissue.
Anatomy of the Rotator Cuff
The shoulder joint is a ball and socket joint formed by the union of the head of the upper arm bone (humerus) and the shoulder socket (glenoid). The rotator cuff is a group of four tendons that join the head of the humerus to the deeper shoulder muscles to provide stability and mobility to the shoulder joint. When the rotator cuff tears, it can cause wear and tear to the shoulder joint and lead to shoulder arthritis. You may experience pain (usually at night) and weakness with the involved shoulder. The most common symptom is the inability to raise the arm above the shoulder to perform overhead activities.
Indications for Rotation Medical Rotator Cuff System
Your surgeon may recommend the rotation medical rotator cuff system for the following conditions:
- Presence of rotator cuff tear arthropathy
- Completely torn rotator cuff that is difficult to repair
- Severe shoulder pain and difficulty in performing overhead activities
- Previous unsuccessful rotator cuff surgery
- Continued rotator cuff pain despite other treatments such as rest, medications, cortisone injections, and physical therapy
Preparation for Rotation Medical Rotator Cuff System
Preoperative preparation for the rotation medical rotator cuff system will involve the following steps:
- A thorough examination by your doctor is performed to check for any medical issues that need to be addressed prior to surgery.
- Depending on your medical history, social history, and age, you may need to undergo tests such as bloodwork and imaging to screen for any abnormalities that could threaten the safety of the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should inform your doctor of any medications, vitamins, or supplements that you are taking.
- You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines for 1 to 2 weeks prior to surgery.
- You should refrain from alcohol or tobacco at least a week before and 2 weeks after surgery.
- You should not consume solids or liquids at least 8 hours prior to surgery.
- Arrange for someone to drive you home after surgery.
- A written consent will be obtained from you after the surgical procedure has been explained in detail.
Procedure for Rotation Medical Rotator Cuff System
Rotation Medical rotator cuff system is usually performed arthroscopically. This is a minimally invasive surgery performed through tiny incisions, about 1 cm each, with an arthroscope - a small fiber-optic viewing instrument made up of a tiny lens, light source, and video camera. The surgery is performed under general or regional anesthesia and involves the following steps:
- Your surgeon makes 2 to 3 small keyhole incisions over the affected shoulder to expose the treatment area.
- An arthroscope is inserted through one of the incisions. The camera attached to the arthroscope displays the image of the treatment area on a monitor, allowing your surgeon to determine the amount of rotator cuff damage.
- Miniature surgical instruments are inserted through the other incisions to remove the damaged part of the rotator cuff tendon and injured surrounding tissue to prepare the area for the new tissue implant.
- A bioinductive tissue implant is placed over the injured tendon.
- Dissolvable sutures are then used along the outer margin of the implant to fasten it to the native rotator cuff tendon.
- Upon completion, the scope and instruments are withdrawn and the incisions are closed and covered with a bandage.
Postoperative Care and Instructions
Following the procedure, your arm is placed in a sling to rest the shoulder and promote healing. You may remain in the hospital the night of the surgery and discharged the next day. Pain is controlled with medication and ice packs. You will be instructed to keep the surgical wound dry and wear your sling while sleeping for a few weeks after the procedure. The sling may be removed in 3 to 6 weeks. Rehabilitation usually begins early on the first postoperative day with finger movements and passive assisted range of motion exercises. A physical therapy program is recommended for 3 months after which you can return to your regular activities. A periodic follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
Rotation Medical rotator cuff system is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as the following:
- Blood clots or deep vein thrombosis (DVT)
- Anesthetic/allergic reactions
- Injury to nerves and blood vessels
- Postoperative shoulder pain/stiffness