Throughout the human body, muscles are connected to bones by bands of connective tissue called tendons. These tissue bands enable movement by transferring the force of muscle contractions to the bones. While the shoulder girdle houses a number of different tendons, there are three that are more commonly recognized as part of the shoulder. These three tendons attach to various points on the shoulder blade (scapula) and upper arm bone (humerus). The rotator cuff contains four different muscle-tendon pairs: the infraspinatus, supraspinatus, subscapularis, and teres minor. The biceps tendon anchors the proximal biceps muscle to the shoulder blade (scapula) via two different attachment sites. The short head of the biceps tendon emanates from the coracoid process of the scapula and the long head of the biceps tendon originates from the superior glenoid cavity of the shoulder blade. The pectoralis major tendon connects the pectoralis major muscle of the chest wall to the bicipital groove of the upper arm bone (humerus).
When an individual sustains a blunt force trauma directly to the shoulder, one or more tendons can be pulled away from their attachment sites on the bone. This partial or complete separation of the tendon is known as a shoulder tendon injury. Athletic individuals are often the most vulnerable to experiencing a shoulder tendon injury; however, non-athletic individuals are also susceptible to this type of shoulder joint injury. Dr. Frank McCormick, orthopedic shoulder doctor, treats patients in Orlando, Palm Beach County, and surrounding Florida communities, who have experienced a shoulder tendon injury and are in need of surgical repair.
Patients with mild shoulder tendon injuries frequently respond well to treatment with conservative therapy options. However, those with complete tendon ruptures may require surgical intervention. There is currently a myriad of surgical techniques that can be implemented to treat shoulder tendon injuries. While there are subtle differences between these repair methods, they are often performed arthroscopically utilizing a small camera (arthroscope) and specialized surgical instruments.
A rotator cuff repair begins with excision and removal of any damaged tendon fragments. This debridement procedure may be all that is necessary for treating a partial rotator cuff injury. The healthy tendon remaining is then reattached to the correct anatomical position on the humeral head using special surgical anchors that are secured within the bone. Dr. McCormick treats rotator cuff injuries with an additional row of sutures to the damaged tendons. This advanced surgical technique is known as a double-row rotator cuff repair.
Any damaged tissue fragments are first excised and removed from the biceps tendon. A tenotomy procedure then follows where the remaining biceps tendon is carefully separated from its attachment point on the shoulder blade. The biceps tendon is then fastened to a new attachment site on the humerus with special surgical anchors that are secured within the bone.
A pectoralis major tendon repair begins with a debridement procedure involving the removal of any frayed or damaged tissue fragments from the pectoralis major tendon. The healthy tissue remaining is reattached in its native anatomical position and secured in place with special surgical anchors. In rare instances, Dr. McCormick may implement a tendon graft harvested from either the patient (autograft) or donor tissue (allograft). The tendon graft serves as a tool to lengthen the pectoralis major tendon, if tendon retraction occurs, or can be used to reconstruct the tendon in its entirety.
For more information on shoulder labrum and SLAP tear repairs, or to discuss your shoulder labrum treatment options, please contact the office of Frank McCormick, MD, orthopedic shoulder doctor serving Orlando, Kissimmee, Palm Beach County, Florida, and the surrounding areas.
