Treatment for Vitamin D Deficiency

The use of a new surgical instrument for use in shoulder surgery is both safe and may be beneficial for patients presenting with these symptoms.

Routine repair of rotator cuff tears is often recommended for asymptomatic patients older than 50 years of age. In symptomatic patients, the decision to surgically repair cuff tears depends on a patient's functional status, medical comorbidities, and preference. Surgical repair can improve a patient's function and reduce postoperative pain and stiffness.

Rotator cuff tears can be diagnosed with clinical examinations and imaging studies. However, most clinicians prefer direct examination, history taking and physical examinations of the shoulder to get the most accurate information regarding symptom history, pain, and function. Magnetic resonance imaging can be used for diagnosis when the clinical condition and history of the patient do not allow a certain diagnosis of the lesion. As the rotator cuff tear has a great impact on the shoulder function, appropriate surgical treatments have to be conducted in order to restore an effective functioning of the shoulder joint. Moreover, there is a need for further education of both medical readers as well as general population in order to reduce the prevalence of rotator cuff tears and to detect them earlier.

Over 210,000 people in the United States will be diagnosed with a rotator cuff tear each year. Most common are rotator cuff tears due to increased workloads in manual workers' professions (69.8%) and in sales/marketing/management professionals (65.8%); the most common cause of tear are repeated motions in manual work and the use of heavier loads in sales/marketing/management occupations.

Based on these findings from this single-patient case with no post-operative follow-up and no radiologic evidence of rotator cuff healing, the best and/or only conclusion to reach regarding rotator cuff repair after failed primary tendon repair is that the "surgical failure" is not irreparable. It is certainly not. As the cuff heals, the results seem good and encouraging.

The symptoms most frequently reported regarding shoulder pain were pain while performing a variety of movements. The main finding regarding a change in shoulder motion, regardless of the person's complaint, was a decrease in abduction.

Rotator cuff tear is commonly treated with arthroscopic repair. Repair of ruptured tendons is the preferred technique, but repair of cuff tears is less successful with partial repair, and surgical repair is preferred when repairs fail.

The majority of recent clinical trials involving treatment of rotator cuff tears are not published in peer-reviewed journals. We need to encourage clinical trials to generate scientific data, which can serve as the core of the medical literature, and thereby make the medical community and the lay public aware of the potential benefits and risks of each treatment option.

Treatment for rotator cuff tears is often multimodal, combining conventional and minimally invasive surgical techniques. One approach is the surgical repair of the rotator cuff, including arthroscopic repair of partial tears; the other is arthroscopic repair of complete tears, usually without repair at first.

As a result of the advances in the understanding of rotator cuff healing and the clinical results, the rate of rotator cuff tears from degeneration or aging has likely increased. There continues to be no strong evidence that exercise is effective for rotator cuff tears. However, the recent studies concerning the efficacy and effectiveness of exercise and physical therapy for degenerative rotator cuff tears are still insufficient. More research is needed.

Routine clinical examination and imaging studies provide sufficient data at the time of diagnosis to determine the primary cause of rotator cuff tears. Routine clinical examination of the shoulder is inadequate to detect and define the primary cause of rotator cuff tears.