Rotator Cuff Repair
The rotator cuff is a combination of muscles and tendon which link upper arm bone, humerus to your shoulder blades. The rotator cuff holds the upper arm bone in right place in shoulder socket. There are four muscles in rotator cuff which are supraspinatus, infraspinatus, teres minor and subscapularis. Each muscle is connected to the arm bone by tendons. The rotator cuff surgery is used to repair any tear in any of these tendons.
The rotator cuff injury can happen to anyone. You can hurt your rotator cuff through wear and tear or poor movement over time. As you get aged, the rotator cuff gets irritated by calcium deposits in shoulder area or bone spurs due to arthritis. The symptoms of rotator cuff include:
- Shoulder Weakness.
- Pain in shoulder when you lift or pull.
- Decrease in range of motion in shoulder joint.
A physical exam and medical history is very important for the proper diagnosis of the injury. A complete medical history is needed. Doctor will perform physical exam. The doctor will give some tests to be performed to confirm the diagnosis.
After getting the results, doctor will decide whether the surgery is required or not. If the surgery is required, the surgeon will examine the shoulder using an arthroscope. It is not always required. During an arthroscopy, a small camera is inserted to check the shoulder. During the procedure, anesthesia is given at first. The doctor will make a cut and insert camera linked to video monitor. The doctor will use the camera to take a look on tendons, ligaments, and cartilage to check whether the surgery will solve the problem or not.
Deciding On Rotator Cuff Repair Surgery
Surgery is not the first recommended treatment for shoulder injuries. Doctors recommend rest, ice packs, and some exercise. If the injury is not so severe, these treatment approach will be enough. If the tendon is torn, then surgery is required.
You can go for the shoulder surgery if:
- You have shoulder pain for more than 6 months.
- You have shoulder weakness.
The rotator cuff surgery will work best on any recent injury rather than any chronic condition.
Preparing for surgery
Rest and cold packs are best to ease the shoulder pain while waiting for surgery. The doctor will recommend some exercise to help with pain. Some over-the-counter drugs such as aspirin, ibuprofen and naproxen are given. Some pain killers are also given.
First you will receive a general anesthesia. After that it is done with either an arthroscope, open or small incision. If the doctor want to do the surgery with arthroscope, they will put a small camera in one hole and will make one to three small cuts for instruments. The surgeon will use these instruments to reattach tendon to bone. Once the tendon is at the right place, surgeon will attach it with sutures. Surgeon will often use small rivets called as suture anchors. These rivets can be metal or material which will dissolve eventually. The sutures attach to the rivet, reattaches the tendon from where it was torn.
If the rotator cuff tear is large, then you will need a open incision instead of arthroscopic approach. The cut can be 2.5 to 4 inches long for regular open repair or 1.25 to 2 inches for mini-open repair.
Mini-open surgery is required if the doctor wants to remove calcium deposits or bone spur. Bone spur can also develop as people grow old. When the cuts are stitched, then a clean dressing is applied.
Every surgery carries some risk which include nerve damage, infection, and excessive bleeding. In some cases, the patient may be allergic to anesthesia or suffer from breathing problems during procedure.
After surgery, doctor can instruct you to keep arm in sling for 4-6 weeks. You may need to wear shoulder immobilizer. This will help shoulder to hold at 1 place. Some pain medications and exercises are also recommended. Recovery may take 3-6 months depending on nature of shoulder injury.