Rotator Cuff Repair

Rotator cuff repair surgery is typically indicated in the following situations:

• Persistent Pain and Weakness: Patients experiencing ongoing pain and weakness in the shoulder, especially after nonsurgical treatments like physical therapy, medications and injections have failed, may be candidates for surgery.
• Severe Rotator Cuff Tears: Acute, complete rotator cuff tears resulting from injuries, and large or complex tears that do not respond to conservative treatment, often require surgical intervention.
• Decreased Functionality: A significant loss of range of motion or strength in the shoulder that impedes daily activities can necessitate surgery.
• Occupational or Athletic Requirements: Individuals whose job or sports activities are heavily reliant on shoulder function may opt for surgery to regain full capability.

Repair involves reattaching the torn rotator cuff tendons to the upper arm bone using suture anchors. Rotator cuff repair surgery can be performed using various techniques, depending on the severity and nature of the tear, as well as patient-specific factors. The goal is to anatomically fix the tendon back to the bone. When there are other shoulder issues like bone spurs, they may also be addressed. Incisions are closed with sutures or staples. Regenerative substances such as stem cells and platelet-rich plasma may be employed during surgery to enhance healing.

The most common methods include:

• Open Repair: A traditional approach involving a larger incision to access the shoulder muscles and tendons. This method is generally reserved for large or complex tears.
• Arthroscopic Repair: A minimally invasive technique using small incisions and an arthroscope (a small camera) to guide the surgery. This approach is favored for its potentially quicker recovery time and reduced pain post-surgery.
• Mini-Open Repair: Combines arthroscopy for assessment and treatment of damage within the joint, followed by a small incision to repair the rotator cuff.

The recovery process is crucial for the success of the surgery and typically involves the following phases:

1. Immediate Postoperative Care: Patients often wear a sling to immobilize the shoulder. Pain is managed through medications.
2. Physical Therapy: Rehabilitation begins with gentle exercises to increase mobility, usually starting a few weeks post-surgery. Physical therapy is essential to regain strength and function.
3. Gradual Increase in Activity: Over several weeks to months, activities are gradually increased under the guidance of the healthcare team. It’s important to avoid strenuous activities or lifting heavy objects during this period.
4. Long-term Recovery: Full recovery can take several months. Most patients experience significant improvement in pain and function, but complete recovery varies based on the individual’s age, overall health, the severity of the injury, and adherence to rehabilitation protocols.

The success rate of repair surgery is generally high, but outcomes can vary based on the size of the tear and the patient’s overall health and activity level. Patient compliance with post-surgical instructions and rehabilitation is crucial for a successful outcome.