Rotator cuff surgery

Types

The type of repair surgery you need will largely depend on the size of your tear, your anatomy, and the quality of the tendon tissue and bone. Rotator cuff surgery types include open, mini-open, and minimally invasive arthroscopic procedures.

  • Open repair is when a traditional surgical incision that is several centimeters long is made over the shoulder. The deltoid shoulder muscle is detached to gain better access to the torn tendon. Open repairs are a good option if the tear is large or complex or if additional reconstruction is necessary.
  • Arthroscopic repair is done with miniature instruments, a small camera (called an arthroscope), and a television screen. It requires only tiny incisions because the instruments are very thin. Arthroscopic surgery is minimally invasive and is usually an outpatient procedure.
  • Mini-open surgery combines minimally invasive arthroscopic techniques with a smaller open procedure. These approaches result in smaller incisions, less pain, and a shorter recovery period than open surgery. Mini-open repairs use arthroscopy to assess and repair the damage to the joint. It avoids needing to detach the deltoid muscle. Still, your surgeon will go in after the arthroscopic portion of the surgery is complete to repair the rotator cuff through a 3 to 5-centimeter incision. Your surgeon will view your tendons directly instead of on a video monitor

Risks

As with any surgery, there are risks to rotator cuff surgery. Though complications are rare, there are risks associated with any general surgery and risks specific to rotator cuff procedures. They include:

  • Blood loss.
  • Infection at the surgical site.
  • Allergic reaction to medicines or the drugs used anesthesia.
  • Nerve injury, usually related to your deltoid muscle.
  • Deltoid detachment. If you have an open repair, your deltoid is moved for the procedure. In rare cases, the muscle can detach if it is not protected after the surgery to heal fully.
  • Stiffness in the shoulder joint, though this side effect can often be avoided with early rehabilitation.
  • Surgical failure or tendon re-injury. If you had an extensive initial tear, there is some likelihood that the repair won’t “hold,” or that you will reinjure your shoulder later on. In this case, repeat surgery may be needed if you have significant pain or lack of functionality associated with a new injury.

Preparation

Before your surgery, you may be asked to stop taking certain medications or supplements. You will need to stop smoking and should tell your care team if you develop cold or flu symptoms before the procedure. You will likely be asked to stop eating and drinking the night before surgery. It is essential to follow your doctor’s instructions carefully to have the best possible surgical outcome.

You will need to be prepared with someone to bring you to and from the surgery. The surgery itself usually lasts two hours, after which you will spend about an hour in the recovery room. Surgical and recovery times will vary. Depending on the type of surgery you receive, you may go home the same day or spend a few nights in the hospital.

Recovery

Many patients have to wear a sling to keep their shoulder stable while healing, and will also need physical therapy as part of the recovery process. Be sure to follow any of the self-care instructions you are given.

Gradually, you’ll be able to regain shoulder function, strength, and stability while fully recovering in three to 12 months. When you are able to return to work or sports will depend on the surgery you had.

Results

After rotator cuff surgery, most people return to their favorite activities and sports. However, surgery won’t prevent future shoulder injuries.

You can protect your shoulder and avoid future problems by:

  • Practicing good posture
  • Carrying heavy objects close to your body
  • Sleeping on the opposite side to avoid pressure on your shoulder
  • Strengthening your shoulder muscles with recommended exercises
  • Using proper body mechanics when lifting heavy objects

Additionally, some rotator cuff tears will not fully heal. Unsatisfactory results may happen because:

  • The rotator cuff was weak or torn before it was injured
  • The rotator cuff muscles are severely weakened
  • You do not follow post-surgical instructions
  • You are over age 65 or smoke
  • The tear was large

In general, rotator cuff repair is a successful surgery in that it relieves shoulder pain. Closely following post-operative instructions will help you keep your shoulder strengthened and healthy to avoid re-injury.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.