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Rotator Cuff Repair

Surgical intervention for a rotator cuff tear may be recommended if non-surgical management fails or if the tear is severely debilitating with a loss of strength and motion (often seen with a full thickness tear).  The goal of a rotator cuff repair is to reattach the entire rotator cuff back to the humerus.  This procedure can be performed in several different ways depending on the patient’s age, tissue quality and severity of the tear.

 

Under normal circumstances, a rotator cuff repair is performed as an arthroscopic procedure.  Although more invasive, occasionally an open procedure is required to perform the repair.  Shoulder arthroscopy is a procedure in which orthopedic surgeons inspect and repair pathology in the shoulder joint. The operation is performed at a hospital or outpatient surgical center.  A thin camera is inserted into the shoulder through 2 or 3 incisions each ¼ inch long. Sterile saline fluid is "pumped" into the shoulder joint for a clear view inside the shoulder capsule. Small hand and motorized tools are used to visualize and repair the damaged tissues.  If the rotator cuff is partially torn, the portion that is still intact will be cut and the entire tendon will be reattached to the surface of the bone.  Regardless, with any repair of the rotator cuff, the tendon is brought back to the attachment site at the humerus and is secured with either absorbable or metal anchors.  The patient is discharged to home an hour or two later the day of surgery.

 

To protect the repair, a sling with a cushion is worn for 4-6 weeks.  Rehabilitation will begin within one to three days after surgery to begin passive range-of-motion and to learn home exercises.  Gradual restoration of motion will occur over the first four weeks.  Eventually a gentle strengthening program can be initiated per the surgeon’s orders and a rehabilitation specialist’s guidance.  Generally, full strength and return to function is seen within 4-6 months after the repair.

 

Any surgical procedure has possible risks and complications. Surgeons make every effort to minimize them. They include:

  • Nerve Damage
  • Infection
  • Deltoid Detachment
  • Stiffness
  • Tendon re-tear