Rotator Cuff Repair
When a rotator cuff tear is large or nonsurgical treatments are ineffective, surgery will be recommended. The goals of surgery are to get the tendon to heal back to the bone to relieve pain, improve shoulder function and prevent further damage to the shoulder joint.
Most rotator cuff repair surgeries are performed on an outpatient basis. This means that patients can go home on the same day as the surgery and do not need to stay overnight in the hospital.
The majority of rotator cuff repair surgeries are performed arthroscopically, which is a minimally invasive surgical technique that uses small incisions and a tiny camera to guide the surgeon.
Arthroscopic surgery is less invasive than traditional open surgery, which means that it is typically associated with less pain, shorter recovery time, and a lower risk of complications.
There are several repair options. The most appropriate treatment will depend on the size of the tear; the patient’s anatomy, age and overall health; tendon and bone quality, and the type of surgical technique used.
- Open repair: This is the traditional method of repairing a torn rotator cuff, and it involves making a large incision in the shoulder to access the torn tendon. The tendon is then reattached to the bone with sutures. Open repair may be recommended for larger or more complex tears.
- Arthroscopic repair: Arthroscopic repair is a minimally invasive surgical procedure that uses small incisions and a tiny camera to view the shoulder joint. The surgeon uses specialized instruments to repair the torn tendon. Arthroscopic repair is usually recommended for smaller, less complex tears.
- Mini-open repair: This technique combines aspects of both open repair and arthroscopic repair. A small incision is made to view the tendon, and it is then repaired using arthroscopic instruments.
- Reverse total shoulder replacement: This procedure is typically used for patients with very large or irreparable rotator cuff tears. It involves removing the damaged joint and replacing it with an artificial joint that allows the deltoid muscle to take over the function of the rotator cuff muscles.
- Patch augmentation: For some larger or more complex tears, the surgeon may use a patch to help reinforce the repaired tendon. The patch can be made of synthetic material or from a portion of the patient’s own tissue.
Recovery and rehabilitation after rotator cuff surgery are crucial for a successful outcome. Here are some general guidelines for the recovery and rehabilitation process:
- After surgery, the shoulder may be immobilized in a sling for several weeks to allow for healing of the rotator cuff repair. The duration of immobilization will depend on the type and extent of the rotator cuff repair and the surgeon’s preference.
- Pain and discomfort are common after rotator cuff surgery. Medications such as acetaminophen, ibuprofen, or prescription pain medication may be prescribed to manage pain and promote comfort.
- After the initial healing period, physical therapy is typically recommended to help restore range of motion, flexibility, and strength. The physical therapy program usually begins with gentle range of motion exercises and gradually progresses to strengthening exercises as healing progresses.
- Certain activities may need to be avoided during the recovery period to prevent reinjury. Patients should avoid lifting heavy objects, reaching overhead, and performing repetitive shoulder motions until cleared by their surgeon.
- As the shoulder heals and strength improves, patients can gradually return to their regular activities. It is important to follow the guidance of the surgeon and physical therapist to avoid reinjury.
Recovery and rehabilitation after rotator cuff surgery can take several months, and patients may require ongoing physical therapy and exercise to maintain shoulder strength and function. It is important to have realistic expectations and follow the rehabilitation program to achieve the best possible outcomes. It is also important to communicate with the surgeon and physical therapist about any concerns or issues that arise during the recovery and rehabilitation process.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in diagnosing and treating shoulder injuries. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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