Surgical Information - Procedures

Rotator Cuff Repair

What is rotator cuff repair?

Rotator cuff repair is surgery to repair a torn tendon in the shoulder.

Rotator cuff disorders come in a variety of degrees and the complexity of the tear usually dictates the repair approach:

  • Smaller, less complicated rotator cuff tears can sometimes be fixed arthroscopically. In this minimally invasive approach, the surgeon makes several small incisions around the shoulder joint and inserts a narrow fiber optic scope (called an arthroscope) to examine the condition of the rotator cuff. Tiny instruments are used to remove loose debris, sew the torn edges of the tendon together and attach it to the humerus (upper arm bone). This minimally invasive approach offers numerous benefits including less muscle and tissue trauma, less bleeding, less pain and a much faster recovery. Patients usually go home the same day.
  • Open rotator cuff repair now uses minimally invasive techniques for many types of tears. The surgical incision is usually only a few centimeters and the surgeon is able to look directly at the torn tendon while repairing it. Open rotator cuff surgeries are outpatient procedures and patients go home the same day.

Anatomy

The rotator cuff is a group of tendons and muscles in the shoulder connecting the humerus to the The rotator cuff is a group of tendons and muscles in the shoulder connecting the humerus to the scapula (shoulder blade). Rotator cuff tendons help stabilize the shoulder joint and rotator cuff muscles help you raise and rotate your arm.

There are two different types of rotator cuff tears. A partial tear damages the soft tissue, but does not completely sever it. A complete tear, also called a full-thickness tear, splits the soft tissue into two pieces. In many cases, the tendons tear off where they attach to the head of the humerus.


Source:AAOS

When is surgery recommended?

Surgery is used to treat a rotator cuff tear if the injury is very severe, or if nonsurgical treatment – rest, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs) and cortisone injections – has failed to improve strength and movement. It’s also a good option for patients who are highly motivated to return to a very active lifestyle. Untreated full thickness rotator cuff tears can cause significant instability of the shoulder, leading to arthritis, weakness and loss of motion.

In younger and middle-aged patients, surgery is the treatment of choice for a full-thickness tear if the tendon is repairable. Partial tears often respond to conservative treatment and heal without surgery.  For older patients with natural degeneration, the decision to have surgery is based on a number of factors including symptoms, function, repairability and tissue quality.


Source:AAOS

Source:AAOS

 

What is the recovery time?

Recovery can be rapid or prolonged depending on the extent of the tear and the surgery required to fix it. It usually begins with three to four weeks of immobilization in a sling, depending on the extent of the tear, followed by several weeks of physical therapy to improve strength and function of the shoulder.

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