Rotator Cuff 11 - Surgery for rotator cuff tears - surgical approach

The deltoid-on surgical approach has offered a major advance in the management of cuff lesions because it is cosmetic (see the previous post), efficient, and involves no detachment of the deltoid from the acromion.  A 6-cm long skin incision is made in the normal skin lines over the anterolateral corner of the acromion.

The major tendinous raphe of the deltoid between the anterior and middle thirds of the deltoid is identified. This tendon is split, leaving half of it on either side of the split to facilitate repair. The split is carried down through the bursa and to the cuff where the procedure is carried out.

 Access to different parts of the cuff is achieved by rotation of the arm, rather than by extending the incision.

At the conclusion of the procedure, a side-to-side repair of the deltoid and a subcuticular closure of the skin are carried out leaving an uncompromised deltoid and a cosmetic skin incision.

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