PATHOLOGIES

Syndrome of cuff

The shoulder articulation is stabilized and put into operation with five tendons covering it, hence the naming of the rotator cuff tendons. After aging phenomena (+ + +), hyper use or trauma, these tendons can be injured going from simple inflammation to a complete rupture by undergoing progressive worsening in the absence of effective treatment. One element that can participate in this aggravation is the hook-shaped "beak " of the acromion (upper bony part that covers the cuff).

DIAGNOSTIC

• It affects women more often, average age is 55 years.
• Occupational exposure concept : painters, masons, teachers ...

• Symptoms:
  
  • NOCTURNALPAIN in the shoulder stump radiating towards the outer side of the arm, with insomnia and nocturnal awakenings. These pains are not well treated by simple analgesics.
  • Raising of the painful arm is limited by the pain NEVER WAIT UNTIL REACHING THE STAGE OF BLOCKING of SHOULDER MOVEMENTS => early specialized consultation
• Clinical examination: specialized, several specific maneuvers
• Complementary examinations:
  • Initial check-up: standard radiographs, ultrasound scan
  • Complementary check-up : MRI or arthrography based on previous data

TREATMENT

• Medical : It is always indicated at the beginning of the treatment while waiting for the imaging check-up, it will combine painkillers, anti inflammatories, infiltration and functional rehabilitation.
• Surgical : a revolution thanks to the ARTHROSCOPY which has several advantages and which has also unquestionable superiority over traditional surgery that remains restricted to special cases. Two types of intervention can be performed :
  • Acromioplasty performed in arthroscopy: Quick and simple operation (one day hospitalization), which allows to remove conflict and pressure exerted by the acromion on tendons.
    Indication : tendonitis and ruptures among seniors (70 and over) resistant to medical treatment
  • REPAIRS performed in ARTHROSCOPY: easy intervention through arthroscopy (4 incisions of 1 cm), short hospitalization of 2 days, simple postoperative(some pain), immediate rehabilitation, helps to effectively repair tendons by reinserting them on bone anchors.
    Indication: rupture of cuff tendons among active patients, helps prevent progression to shoulder osteoarthritis.

FOLLOW-UP

Well managed medical treatment with extended rehabilitation can solve the problem in case of tendonitis or rupture among seniors . In other cases, surgical treatment gives excellent results, thanks to the ARTHROSCOPIC techniques. Hospitalizations are very short average of 1-2 days. Rehabilitation is immediate, it will be adapted to the gesture performed. Precautions will be required for repairs with movements and passive rehabilitation for the first month and will be gradually increased . Recovery is complete within the first month for acromioplasty ,and 3-6 months for repairs (the average of 9 months for traditional surgery).