Pennington tore just one of four rotator muscles

(The following is an assessment of Chad Pennington's shoulder injury from Dr. Ken Montgomery, one of the Jets team doctors, who often performs rotator cuff surgery.)<p> The rotator cuff essentially involves four different muscles.<p>

The most common that is torn is going to be one called the supraspinatus up on the top of the rotator cuff, and, in fact, in Chad, that's the one muscle that is torn.

The other three muscles remain intact. He has a full thickness tear of the supraspinatus muscle. The MRI that we have [after] the last game of the season essentially just confirms that that tear remains the same size as it was before; and, in fact, there's less swelling and edema than there was with the initial injury MRI that we had seen.

When you do the operation, you fortunately have the opportunity to look at all different aspects of his shoulder. Of course, sometimes you can find some additional injury that needs to be taken care of. It almost never requires the rehabilitation overall to be changed in any significant way.

So based on his symptoms and his MRIs, we don't expect to find anything different in there. But if there was something else in addition, it would be repaired at the same time and would not change the timetable for recovery.

The size of the rotator cuff tear that Chad has is fairly small, and we can see that based on the MRI as well as from examining him. So it would be extremely unlikely that [the surgery] would be more extensive than the MRI suggests.

I think that the rotator cuff will be repairable through the scope. The only question is that sometimes some surgeons like to do a little mini-open incision, and that's something that Dr.(James) Andrews will leave up to his own discretion at the time of the procedure depending.

The nice thing about arthroscopy is that you can see everything at the time of the procedure and you can probe it to make sure that there are no additional injuries that need to be addressed. And if they do, then they can be addressed at the same time. And as I said before, it should not change the overall recovery time.

When the muscle has been torn, particularly if it's a large tear or it's a tear that's gone on for a long period of time, then it actually pulls away from the bone in a significant way. His has got very minimal retraction, which means essentially that even though the muscle is not connected, it is sitting right next to the area that it needs to be attached to.

Essentially what you do is you go in and you find the edge of the muscle that's torn. You clean it up so that it's a nice, healthy edge and you get rid of any of the tissue that's not sturdy. You clean up the edge of the bone where it detached from, then you put one or two small anchors into the bone, and those anchors are passed through the cuff, and then you tie the rotator cuff on top of those anchors, which essentially just pulls the rotator cuff down back on to the bone where it came from.

Surgery, depending on the complexity, can take anywhere from an hour to two hours.

I would only say that the younger you are, the better quality the rotator cuff tissue is, and the better your healing potential. So his ability to heal this rotator cuff tear when it's repaired is going to be extremely high. We remain very optimistic.

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