Persistent shoulder discomfort or weakness from a damaged rotator cuff can greatly hamper quality of life. If conservative treatments like medication and therapy fail to alleviate symptoms after several months, surgery may provide a definitive solution. By mending frayed or torn tendons, surgery aims to eliminate pain and restore strength and mobility.
Understanding the Rotator Cuff
The rotator cuff designates four muscles originating on the shoulder blade and converging as tendons to cover the humeral head. This tendinous cuff reinforces the shallow shoulder socket and enables you to lift and turn your arm in all directions.
Injuries or age-related degeneration can weaken the rotator cuff tendons. Tears may be partial-thickness, involving fraying or a partial tear, or full-thickness with complete separation from the bone. Pain, stiffness, muscle atrophy and difficulty using the arm can result.
Indications for Rotator Cuff Surgery
If non-operative treatments do not adequately relieve rotator cuff symptoms after 6 to 12 months, surgery may provide the greatest benefit. Your doctor may also advise rotator cuff repair if:
- Your tear exceeds 3 cm
- You have substantial weakness and functional loss
- You require overhead arm positioning for work or sports
- A distinct traumatic event caused the tear
By surgically reattaching tendon to bone, the goal is to facilitate proper healing to improve strength and eliminate pain. Removing bone spurs and smoothing roughened surfaces during surgery can also enhance outcomes.
Rotator Cuff Surgical Techniques
From traditional open repairs to cutting-edge arthroscopic procedures, surgical advances provide options tailored to each patient’s unique case:
Requiring a sizeable incision for adequate exposure, open repair works well for significant tears where tendons retract far from their anatomical insertion. The surgeon must detach part of the deltoid muscle for improved access and later re-secure it.
Surgery Small incisions allow insertion of a tiny fiberoptic camera, providing magnified internal visualization on a monitor. The surgeon inserts specialized instruments through additional portals, sparing the deltoid. After trimming frayed tissue and preparing the bone surface, sutures anchor torn tendon back to its anatomical site.
Beginning arthroscopically, a short open incision permits cuff repair without fully detaching muscles. The surgeon addresses other issues like bone spurs and cartilage damage in less invasive fashion. This technique provides a balance of enhanced visualization while limiting trauma.
Recovering After Rotator Cuff Surgery
Protecting repaired tendons initially is crucial for proper healing. You will likely require a sling for 4 to 6 weeks to restrict movement. Passive range-of-motion exercise usually starts around 6 weeks, followed by gradual strengthening. Regaining full shoulder function requires substantial rehabilitation lasting from 6 months to a year.
Outcomes and Benefits
About 85% to 90% of repaired cuff tears heal successfully based on MRI findings. More importantly, most patients experience considerable pain relief and restoration of strength for lasting gains in comfort and function. Additional benefits may include:
- Quicker recovery and rehabilitation
- Lower postoperative infection rates
- Minimal scarring
- Shorter hospital stays
While open surgery better accommodates some large tears, arthroscopic techniques provide important advantages. Your surgeon will guide the best approach for your individual case.
Risks and Complications
While infrequent, potential surgery risks involve:
- Persistent shoulder stiffness
- Nerve injury
- Failure of the repaired tendon
- Adhesive capsulitis
Appropriate precautions and dedicated participation in post-op rehab can help prevent adverse outcomes. Maintaining realistic expectations about recovery timeframes is also key.
Is Surgery Appropriate for Your Torn Rotator Cuff?
If nonsurgical modalities do not alleviate pain or restore satisfactory shoulder function after 6 months, a consult with an orthopedic shoulder specialist is warranted. Surgical repair techniques continue advancing, providing reliable and less invasive solutions for persistent cases.
Trusted Expertise for Complex Shoulder Issues
With over 20 years of experience performing orthopedic surgery and additional specialty training in limb salvage procedures, Dr. Herrick J. Siegel provides elite diagnostic skills and advanced operative techniques. He offers the latest arthroscopic and open solutions in rotator cuff repair for residents of Birmingham, Alabama and surrounding areas needing shoulder pain relief and improved function. Please call Dr. Siegel’s office to evaluate your options.