Definition

A rotator cuff repair is a surgery to repair damage to the rotator cuff.

The rotator cuff is a group of four muscles in the shoulder and upper arm. Their main job is to move the arm in a circular motion. The muscles are connected to the shoulder bone by tendons, which are strong, flexible cords. Tendons may become damaged from chronic misuse or injury.

Rotator Cuff Tear

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Parts of the Body Involved

  • Shoulder and upper arm
  • Rotator cuff muscles
    • Supraspinatus
    • Infraspinatus
    • Subscapularis
    • Teres minor

Reasons for Procedure

  • A rotator cuff injury which does not respond to conservative treatment.
  • A complete tear in the tendon.
  • Chronic pain and weakness from a partial tear in the tendon.

Risk Factors for Complications During the Procedure

There are no risk factors known to complicate this procedure.

What to Expect

Prior to Procedure

In the days leading up to the procedure:

  • Do not take aspirin or other anti-inflammatory drugs (such as Ibuprofen ) for one week before surgery, unless told otherwise by your doctor. You may also need to stop taking blood-thinning medications. Examples include clopidogrel (Plavix), warfarin (Coumadin), or ticlopidine (Ticlid). Talk to your doctor.
  • Do not eat or drink anything for 12 hours before surgery.
  • Arrange for a ride to and from the procedure.

On the day of the procedure:

During Procedure

You will be given an IV line for medications and anesthesia.

Anesthesia

General anesthesia is typically used.

Description of the Procedure

There are two methods used to perform a rotator cuff repair:

Open Surgery

The surgeon makes a large incision over the shoulder. The torn tendon is mended and reattached and/or anchored with stitches. The incision is then closed with stitches or staples.

Arthroscopic Surgery

A small incision is made in the shoulder, and a narrow, tubular instrument called an arthroscope is inserted. The arthroscope is equipped with a tiny camera and the surgeon uses small instruments inserted through very small incisions. The surgeon performs the procedure while watching live images of the surgery on a monitor. This procedure is usually performed when there is a small tear.

After Procedure

  • The incision will be bandaged to prevent infection.
  • Your arm will be placed in a sling to prevent movement.

How Long Will It Take?

The surgery takes about 1 ½-2 hours.

Will It Hurt?

Anesthesia prevents pain during the procedure. You may have some discomfort immediately after.

Possible Complications

  • Infection
  • Bleeding
  • Reaction to prescribed medication
  • Scarring within the shoulder joint
  • The operation does not provide the desired improvement in function

Average Hospital Stay

You could go home the same day, some may need to stay 1 day.

Postoperative Care

  • Use ice to reduce swelling during the first 24 to 48 hours after surgery.
  • Take the full doses of all medications prescribed.
  • Keep the bandage clean and dry at all times.
  • Do not use the arm until after the sling has been removed.
  • Follow instructions for physical therapy. Therapy is essential to regain shoulder strength and range of motion.

Outcome

After a successful rotator cuff repair, you should expect relief from pain. At least an 80% to 90% of motion should return.

The rotator cuff will take several months to heal. It may take up to six months before you can raise your arm above your shoulder, and up to one year before you can hold your arm above your head and do work with reasonable strength. An aggressive and consistent postsurgical exercise program is the key to an accelerated recovery.

Unless your job requires heavy lifting, you can usually return to work within a few days after surgery.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • The stitches or staples come apart