Surgical Options for the Rotator Cuff

A rotator cuff tear may not heal completely without surgery; however satisfactory function can often be achieved without an operation. If you continue to suffer from persistent pain, weakness or recurring inflammation after trying non-operative treatments, you may require a surgical option.

The type of surgery you require will depend on the size, shape and location of your injury. Your orthopedic surgeon can determine which surgery is most suited to your condition. A number of these procedures can be completed through day surgery; however most will require extensive rehabilitation utilizing the non-surgical procedures. Your surgeon should provide a treatment plan to help you regain normal use as soon as possible.

Arthroscopic surgery involves making tiny incisions around your shoulder joint and inserting a pencil-thin, fiber optic camera with a small lens and lighting system. The surgeon will take a look inside your joint to investigate all the soft tissues and bones. These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the repair under video control. At the end of surgery, your incisions are closed, and a dressing is applied.

Impingement syndrome or a partial thickness Rotator Cuff tear are best treated by this type of surgical repair. They may require a debridement (removal of dead, damaged, or infected tissue) and/or shaving or removal of bone spurs and fragments that can catch when your arm is rotated.

Traditional Open Repair surgery is often preferred if you have a complex or full thickness Rotator Cuff tear. Your surgeon will use sutures (stitches and/or anchors that hold the tissue together after they have been severed) to help attach the tendon back to the tissue or bone. These are made of metal or plastic, and do not need to be removed.

Open repair surgery is also used when additional reconstruction is required, such as a tendon transfer and/or shoulder replacement.

There are always some risks associated with any surgery, which include but are not limited to possible infection, allergic reaction to medications, and damage to surrounding nerves or blood vessels. However, modern techniques have significantly minimized the occurrence of these problems. Tenderness, pain, stiffness and weakness are very common after surgery, but with proper rehabilitation these should diminish.

Surgical therapy is often recommended for younger individuals, people who continuously use their shoulder for work, athletes, or when non-surgical treatments are not effective. Although surgery is often successful at repairing any damage and/or relieving pain, it does not necessarily return strength to your shoulder. That's why a strong commitment to rehabilitation is essential. Healing and recovery time is generally dependent on the extent of your injury, your age, pre-injury level of function, and your commitment to rehabilitation.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!