Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left shoulder pain exacerbated by overhead activities and nocturnal discomfort. Reports significant weakness in abduction and external rotation. No history of acute trauma, though symptoms have progressively worsened over [X] months. Failed conservative management including physical therapy and NSAIDs.
Clinical Examination Findings
Left shoulder examination reveals atrophy of the supraspinatus and infraspinatus fossae. Active range of motion is limited in abduction (to [X] degrees) with a positive drop-arm sign. Passive range of motion is preserved. Strength testing demonstrates 3/5 in abduction and external rotation. Neer and Hawkins-Kennedy impingement signs are positive. Neurovascular status is intact distally.
Treatment Protocol
Recommended surgical intervention: Arthroscopic repair of the complete rotator cuff tear. Pre-operative plan includes MRI confirmation, optimization of comorbidities, and discussion of risks including stiffness, infection, and re-tear. Post-operative protocol involves immobilization in a shoulder abduction sling for 6 weeks followed by a structured physical therapy rehabilitation program.