Surgery may be used to treat a Rotator Cuff if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.
Surgery to repair a torn rotator cuff tendon usually involves:
- Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement).
- Making more room for the rotator cuff tendon so it is not pinched or irritated. If needed, this includes shaving bone or removing bone spurs from the point of the shoulder blade (subacromial smoothing).
- Sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).
Arthroscopic surgery is the most common way that this surgery is done. But in some cases, the surgeon needs to do open-shoulder surgery, which requires a larger incision.
At South Texas Spinal Clinic, however, every attempt will be made to use non-surgical methods to treat a torn Rotator Cuff. Information curated from South Texas Spinal Clinic’s General Orthopaedic Team and https://wb.md/1K2U0tD
What to Expect after Rotator Cuff Surgery
At South Texas Spinal Clinic, our surgeons will prescribe pain medication to help diminish any discomfort you may experience after surgery. Also, you will need to wear your arm in a sling for a defined period of time.
After the defined time in a sling, physical therapy after surgery is crucial to a successful recovery. A rehabilitation program may include the following:
- As soon as you awake from anesthesia, we may help you with exercises that flex and extend the elbow, wrist, and hand.
- The day after surgery, a physical therapist or a machine may help you move the joint through its range of motion.
- After 6 to 8 weeks following surgery, with the assistance from a physical therapist, you will move your arm yourself and perform stretches. This depends on how bad your tear was and how complex the surgical repair was.
- You will be taught strengthening exercises a few months after surgery, and you will start with light weights and progress to heavier weights.
Why It Is Done
Surgery to repair a rotator cuff is done when:
- A sudden injury causes the rotator cuff to tear. It is best to do surgery soon after the injury.
- A complete rotator cuff tear causes severe shoulder weakness and limits range of motion because of pain.
- The rotator cuff has fails to improve with 3 to 6 months of conservative nonsurgical treatment alone, such as physical therapy.
- You need full shoulder strength and function for your job or activities, or you are young.
- You are in good enough physical condition to recover from surgery and will commit to completing a program of physical rehabilitation.
How Well It Works
Rotator cuff repair surgery for a tear caused by a sudden injury has a high success rate when performed within a few weeks of the injury. Repairs made long after the original injury date are not as successful when compared to timely repairs but most patients still report reduced pain levels and improved range of motion.
Rotator cuff surgery to repair large tears is usually less successful than surgery for smaller sized tears. Rotator cuff surgery on frayed tendon tissue weakened by long term wear and tear is usually less successful than surgery to repair an otherwise healthy tendon.
In addition to the risks of surgery in general, such as blood loss or problems related to anesthesia, complications of rotator cuff surgery may include:
- Infection of the incision or of the shoulder joint.
- Pain or stiffness that won’t go away.
- Damage to the deltoid tendon or muscle (if the deltoid is detached, additional surgery may be needed to repair it).
- The need for repeated surgery because tendons do not heal properly or tear again.
- Nerve or blood vessel damage which can happen but is uncommon.
- Complex regional pain syndrome, which fortunately is rare.
What to Think About
Very large tears (greater than 2 inches or involving more than one rotator cuff tendon) often cannot be repaired by this type of surgery. Grafting and patching procedures may be needed. But they are not much better at restoring strength than debridement and smoothing, which are less risky and require less rehabilitation.
Less active people (usually those older than 60) with confirmed rotator cuff tears that do not cause pain, significant weakness, or sleep problems can safely go without surgery unless symptoms get worse.
- Some people who do not have surgery to repair severe rotator cuff tears develop cuff tear arthropathy, a condition of progressive arthritis pain, and significant loss of strength, flexibility, and range of motion.
- In some cases, arthroscopic debridement and smoothing adequately relieves pain and restores enough function to allow daily activities. Surgery to repair the rotator cuff is not needed.
Information curated from South Texas Spinal Clinic’s General Orthopaedic Team and https://wb.md/1OsAsGM .