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Case Study: Rotator Cuff Injury

3012 words - 13 pages

Rotator Cuff Repair
PATHOPHYSIOLOGY
Wells K (2013) defined rotator cuff injury as a condition involving damage to the rotator cuff tendons because of continuous irritation and tear. There are two factors that can predispose a person to this type of injury. The first type is intrinsic factor which means coming from within, this includes poor blood supply to an organ, normal attrition or degeneration with ageing and calcification of tendons. The other factor is called extrinsic factor which means coming from the outside. Some of the factors considered extrinsic are injury from accidents, falls and too much stress on the shoulders as a result of different movements involving exertion (Bilal, ...view middle of the document...

It involves the removal of the injured tissue and bone surrounding the rotator cuff lessening the pressure on the area. The surgeon inserts an arthroscope through a small incision into the shoulder. The device is connected to a video monitor inside the theatre. This is used to view and inspect all the tissues of the shoulder joint and above the area of the joint. Additionally, around 1-3 incisions are made to insert other instruments that will repair any damaged tissues and fix the tear in the muscle, tendon or cartilage. A damaged tissue is then removed out of the injured area. The surgeon may also do a rotator cuff repair by bringing together the edges of the tendon thru small rivets called suture anchors that are attached to the bones. These anchors are made of metals or plastic. They remain inside the shoulder and may not be removed after surgery. Incisions will be closed by stitches and covered with bandages as dressing. Some injuries may require an open surgery due to a lot of damage to the rotator cuff. This would mean that a large incision should be made for a direct access to the bones and tissues (Ma, 2013).
Medications
Aside from surgery, medications will be administered to minimise the symptoms brought about by the injury and the surgery itself. One of the medications administered following surgery is acetaminophen.It is indicated for postoperative pain reduction. It acts by inhibiting the central prostaglandin production resulting to an increase in the patient’s pain threshold. Another treatment will also include analgesics such as Non-steroidal Anti-inflammatory Drugs. These drugs work by minimising the sensitisation of sensory neuron that enhances inflammation associated with pain and prevents the pain sensation from reaching the brain. Opioids such as Morphine are often used to treat moderate to severe pain. This medication can imitate the action of natural opioids in the brain which in return produce the analgesic effect. Tramadol can also be used in conjunction with acetaminophen for effective pain control (Ruiz-Suarez & Barber, 2008).There are also other medications that can be administered to minimise symptoms other than pain. Analgesics such as Ibuprofen and Naproxen can help in decreasing the swelling and pain which often follows a rotator cuff tear. Corticosteroid injection to the shoulder may also be given to decrease inflammation and for pain reduction (Ma, 2013). Constant Infusion devices may also be administered for pain control.
Furthermore, post-surgical pain may result to anxiety and sleep deprivations. Hyperalgesia can cause sleep disturbances therefore sleeping medications are also advisable 24 hours post surgery. Promotion of sleep may result to improvement of patient’s health (Ruiz-Suarez & Barber, 2008).
Non-Pharmacological
Cryotherapy
Cryotherapy is an alternative pain reliever following rotator cuff tear. The first application of cold as analgesia was observed in the time of Hippocrates...

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