The rotator cuff is the thick band of muscles and tendons that covers the top of the upper arm and holds in it place, providing stability and a full range of motion to the shoulder joint. It is made of four muscles and their associated tendons. These tendons can become partially or completely torn as a result of a rotator cuff tear.
A rotator cuff tear most often occurs as a result of overuse of the muscles over a long period of time. As a result, this condition is most common in patients over the age of 40. It may also occur as a result of a traumatic injury, and involve pain when lifting or lowering their arm, muscle weakness and atrophy.
Many rotator cuff tears can be treated through nonsurgical methods that focus on relieving pain and restoring function to the shoulder. These may include:
Surgery may be recommended for tears that cause severe pain or that do not respond to more conservative treatments. The type of surgery performed depends on the size and location of the tear, but often involves trimming torn edges or suturing the tendon back together.
Rotator cuff surgery may be performed arthroscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area.
During arthroscopic rotator cuff repair, several small incisions are made in the shoulder, into which a thin tube and tiny instruments are inserted. The surgeon repairs the tendon through visualization on a television monitor. This technique allows for less scarring and shorter recovery times, but is not ideal for all patients.
Open rotator cuff repair may be performed for large or complex tears, and involves one large incision and detachment of the deltoid muscle to access the rotator cuff. Any bone spurs or torn surfaces will be removed during this procedure, before the tendon is stitched back together.
Once the repair is complete, any incisions will be stitched closed and patients will be moved to a recovery room where they will be monitored post-operatively for a few hours.
Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. Approximately 80 to 95 percent of patients achieve effective pain relief, restoration of function and improved range of motion after their procedure. These results can vary depending on the type of procedure performed as well as the patient's individual condition, age and overall health.
Recovery time depends on the type of surgery, but can take several months. After surgery, the arm will be immobilized to promote proper healing. Physical therapy will begin shortly after surgery to help restore strength and movement and allow patients to gradually resume their regular activities. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results.
As with any surgery, there are certain risks involved with rotator cuff repair such as infection, pain or stiffness, nerve damage or the need for repeated surgery. These complications are rare and most people receive successful outcomes from this procedure. Your doctor will discuss these risks with you, as well as address any concerns you may have, prior to your procedure.
To learn more about rotator cuff repair and to find out whether or not this procedure is right for you, please call us to schedule an appointment.