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Rotator Cuff Surgery


Great Surgical Care at Marina del Rey Hospital

By virtue of state-of-the-art technology, our surgeons can perform a wide range of orthopaedic procedures with minimal risk of postoperative complications. If your rotator cuff is torn, you most likely need surgery to restore the function of your shoulder, which can be performed by using a minimally invasive approach or a traditional one.

Regardless of what type of surgery you need, our talented and experienced surgeons will perform the procedure with utmost care. Afterward, you will be closely monitored by our well-trained medical team so as to avoid any health problems that may arise following the procedure.

This surgery is for people who have a rotator cuff tear. The rotator cuff refers to some muscles and tendons that can be found around the shoulder joint, whose purpose is to keep the top of your upper arm bone firmly within the socket of your shoulder. As a result of injury to the rotator cuff, you can experience a partial tear or a full-thickness tear. While a partial tear damages the tendon but does not severe it, a full-thickness tear separates the entire tendon from the bone.

Every year, roughly 2 million people in the U.S. visit their doctor for rotator cuff injuries. It is worthy of note that the majority of rotator cuff tears occur gradually, over the years, with the wear and tear of these muscles and tendons. Some of the key factors that contribute to degenerative rotator cuff tears are repetitive stress, lack of blood supply, and bone spurs. To become a good candidate for rotator cuff repair surgery, you must meet the following criteria:

  • you have been experiencing symptoms for 6 to 12 months 
  • you have a large tear, greater than 3 cm, but the quality of the surrounding tissue is good
  • you have a considerable loss of function or weakness in your shoulder
  • your tear is the result of a recent, acute injury

During the surgery, the tendon will be reattached to the head of the upper arm bone. This can be achieved by undergoing open repair surgery, arthroscopic repair surgery, or mini-open repair surgery. If the tear is large and complex, you will require open repair surgery, during which the surgeon will remove the bone spurs and repair the rotator cuff. Arthroscopy involves a minimally invasive technique and is suitable for patients who do not have extensive damage to their rotator cuff. Lastly, during mini-open repair surgery, the surgeon will make a 1 to 2-inch long incision and use novel medical technology to repair your rotator cuff.

Before undergoing rotator cuff surgery, regardless of the technique used, you will receive either general or regional anesthesia so that you will experience no pain or discomfort while the surgeon is carrying out the procedure. If you are given regional anesthesia, you will also receive a sedative that will make you calm and sleepy, as naturally, you may be nervous during the surgery. When the surgery is over, every incision will be closed by using sutures, and the surgeon will apply a sterile dressing on the surgical site. If you had arthroscopic surgery, the surgeon might take photos of the procedure from the video monitor to show you what the problem was and what repairs were made.

The primary benefits of rotator cuff surgery are the disappearance of shoulder pain and the restoration of strength in your shoulder. If you have arthroscopic rotator cuff surgery, you will enjoy more benefits following the procedure, namely:

  • having a less invasive surgery, which considerably lowers your risk of postoperative complications
  • a shorter recovery period since the surgery is less invasive, which means that you may return home on the same day
  • having a low risk of complications following the surgery since the surgeon does as little damage to your shoulder area as it is necessary to insert the medical instruments

Other benefits of undergoing rotator cuff surgery include the following:

  • a return of complete range of motion in your shoulder
  • complete pain relief in your shoulder
  • no more shoulder muscle weakness
  • sleeping better due to the disappearance of pain in your shoulder
  • regaining the ability to lift objects over your head when you are fully recovered

Recovery

After rotator cuff surgery, you will have to wait between 4 and 6 months to experience a full recovery, based on the extent of your injury. It is important to know that recovery occurs in several different stages. The first step is managing your pain with anti-inflammatory medications such as ibuprofen or aspirin, applying ice to the surgical site, and resting as much as possible. Your arm will be immobilized in a sling for 4 to 6 weeks following the procedure. However, you will be allowed to return to your normal routine shortly after your rotator cuff surgery, but you will have to use only one arm – the healthy arm – to perform activities such as driving.

While your shoulder is healing, you will do physical therapy to ensure it is healing correctly and to make sure it will be as good as new after the surgery. The goal of physical therapy is to regain motion and strength in your affected shoulder. It is worthy of note that you may have to wait longer than 6 months before you can lift heavy objects. The bottom line as far as recovery goes is that you should always follow the advice of your orthopaedic surgeon, as each case of torn rotator cuff is unique and requires special care.

Risks

As with any other invasive surgical procedure, there are several risks involved in rotator cuff surgery, the most common being the following:

  • infection, which may be identified by abnormal redness, swelling, pain, and drainage of the incision
  • shoulder stiffness, which up to 20% of patients experience following rotator cuff surgery, but which goes away by itself within 6 to 12 months
  • lack of improvement, which means that you may not regain full motion, strength, and function in your shoulder if the procedure fails
  • nerve injury, which only 1% to 2% of patients experience because the shoulder joint is surrounded by numerous major nerves
  • retears, which usually happen with larger tendon tears, but which may be avoided if you follow the rules your surgeon gave you during recovery

Complications

While the rate of complications is low for rotator cuff surgery, some patients may, unfortunately, experience various problems that range in severity after they undergo this procedure, even if their orthopaedic surgeon has taken all the preventive measures possible. These complications are typically associated with rotator cuff surgery:

  • deltoid detachment
  • injury to adjacent nerves and blood vessels
  • allergic reaction to anesthesia
  • bleeding during or after the surgery
  • unsightly scarring of the skin
  • blood clots

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