Managing an Injured Rotator Cuff: From Therapy to Surgery and Everything In-Between

Original Release Date: October 1, 2021

In this webinar participating claims professionals and employers learned the anatomy of the rotator cuff, common mechanisms of injury, and methods to prevent injuries in the workplace.  Additionally, we reviewed the common symptoms and the workup including x-rays, MRI, CT scans, and physical exam findings. Treatment options were discussed including medications, injections (cortisone, platelet-rich plasma, hyaluronic acid, prolotherapy), physical therapy, acupuncture massage therapy, and surgical options.

Dr. Weitzel reviewed and showed different types of rotator cuff injuries and the surgical techniques used to treat various rotator cuff injuries ranging from repair to replacement and newer techniques.  Video images are shown. Post-operative rehabilitation and timelines to return to work including data obtained from Care Pathway including the anticipated time to work with restrictions and full duty. At the conclusion of this webinar, participants were able to identify common risk factors for workplace injuries of the rotator cuff, the presentation, and the evaluation of the industrial workers.  Modalities utilized in surgical and non-surgical management of rotator cuff injuries and anticipated recovery timelines after a patient is injured.

Watch the webinar to learn:

00:00 Introduction

1:48 Welcome to the Injury Insight Series

2:16 About this Session

2:55 Presenting Session Speaker

3:54 Disclosures

4:29 Presentation Overview

5:44 Shoulder Anatomy

6:12 Anatomy – Rotator Cuff Four Tendons

7:15 Mechanics – Cavity Compression

8:18 Tear Incidence

10:34 Mechanism of Injury

13:10 Prevention

14:51 History

15:36 Shoulder Physical Exam

23:00 Imaging

24:58 MRI – Excellent at Evaluating Soft Tissue and Chronicity of Injury

27:28 Rotator Cuff Tear on MRI

27:53 What We Loot at on MRI

30:38 Tangent Sign

31:36 Results of RCR Based Upon Atrophy

32:51 Progression Over Time

34:09 Non-operative treatment

34:36 Physical Therapy

36:13 Physical Therapy for Atraumatic RCT

37:07 Injections

37:15 Cortisone

38:52 Platelet Rich Plasma – Controversial

40:05 Hyaluronic Acid

40:49 Prolotherapy

41:02 Medication

41:41 Acupuncture

42:23 Massage Therapy

42:42 Surgery

43:37 Surgery Results

44:05 Rotator Cuff Repair

44:22 Single-Row Repairs

45:26 Double-Row Repairs

46:12 Evaluation of Tear and Proper Repair

46:29 Stiches in Place

46:50 Knots

47:14 Second Row Fixation

47:38 Suture Bridge

47:57 Incidence of Retear?

48:15 My Technique

49:12 Post-op Therapy

49:55 Irreparable Massive Tears

50:20 Extensive Debridement

50:24 The InSpace Balloon

51:12 InSpace – Subacromial Balloon

51:31 Superior Capsular Reconstrustion

52:08 Superior Capsular Reconstrustion (SCR) Results

52:52 SCR

53:09 Reverse Total Shoulder Replacement

53:14 A French Idea

53:55 Muscular Strength

54:40 Results of Reverse for Chronic Rotator Cuff Tear

55:27 Results of RSR for Failed RCR

56:05 Care Pathways

57:11 Return to Work

59:28 Q&A Section

1:01:14 Conclusion