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Connecting the upper arm to the shoulder blade, the rotator cuff is one of the most common sources of a shoulder injury. Surgery isn’t always necessary to repair a rotator cuff that’s torn, strained, or otherwise damaged in some way. Non-surgical treatments include:
- Modification of activities
- Immobilization of the affected shoulder
- Pain or anti-inflammatory medications
Assessing the Damage
The approach to surgery that’s recommended will depend on several factors. The first is the severity of the tear. A rotator cuff may be partially torn or completely torn and detached from the upper arm or shoulder blade. Additional factors include the quality of the tissues involved and the patient’s anatomy. Arthroscopic surgery may be performed to get a better view of the affected tendons and muscles. If surgery is necessary to repair the rotator cuff, it may involve:
- Debridement: Removal of loose debris from the area where the affected rotator cuff is located.
- Bone Shaving/Bone Spur Removal: Additional space is created for the rotator cuff tendons and muscles by either shaving bone or removing bone spurs.
- Sewing/Reattaching Tendons: The detached tendon is sewn or reattached to the upper arm bone.
Arthroscopic Rotator Cuff Repair
While effective, traditional open surgery may also result in unintended damage to nearby tissues and often involves a longer recovery period. An increasingly common alternative is arthroscopic rotor cuff repair. It’s a minimally invasive procedure that involves small incisions and the use of a small camera that will guide the surgeon to the correct part of the shoulder. This type of surgery is usually an outpatient procedure.
Mini-Open Rotator Cuff Repair
This method of rotator ruff repair also involves the use arthroscopic techniques to view the shoulder and assess the damage. It’s a technique sometimes used to remove obstructions such as bone spurs without the need to remove the deltoid muscle to get to the affected area. It’s considered a “mini-open” procedure because only part of it is performed arthroscopically. For the rest of the surgery, the surgeon will view the rotator cuff directly instead of on a video monitor.
What Happens After Rotator Cuff Repair?
Non-steroidal anti-inflammatory drugs (NSAIDs) and pain medications are taken immediately after rotator cuff repair to minimize discomfort. Recovery involves a personalized physical therapy plan that’s based on a patient’s capabilities. Sessions typically involve exercises to recondition and strengthen muscles and tendons that were affected during surgery. Initial exercises often involve simple stretches. As healing continues, patients are taught how to safely recondition their shoulder.
Unless the damage to the rotator cuff is severe or involves a widespread injury to a shoulder and arm, the general recommendation is to wait for at least 6-12 months before considering surgery. Full recovery from rotator cuff repair surgery typically takes 3-4 months, although each patient will heal differently. It’s a fairly common procedure that often results in less pain and faster healing when performed arthroscopically, and an increase in shoulder flexibility and range of motion.