Rotator Cuff Surgery


A rotator cuff tear is a common cause of shoulder pain. The rotator cuff tear may be acute, happening suddenly after a fall or accident, or degenerative, as the tissue wears down over time. Rotator cuff tears can get worse over time, and while nonsurgical treatment can relieve pain and improve shoulder function, it often cannot restore strength in the shoulder. Surgery is necessary to regain strength.

Types and Symptoms of Rotator Cuff Tears

Rotator cuff tears often begin through a gradual wearing-down of the rotator cuff tendons. Over time, repetitive stress, bone spurs, or the normal wear-and-tear of aging can cause these tendons to fray like ropes. This can eventually progress into a tear. Sometimes the rotator cuff can tear as the result of a traumatic injury, like a fall onto the arm.

A rotator cuff tear may be classified as either a partial tear or a full-thickness tear. If the soft tissue is damaged, but the tendon is not completely severed, it is a partial tear. If the soft tissue is completely split in two, it is a full-thickness tear.

If your rotator cuff is torn, it may be painful to lift and lower your arm. You may even feel pain in your shoulder while at rest or at night, especially if you lie on the injured shoulder. The shoulder may be weak, making it difficult for you to lift or rotate the arm. You may also experience a crackling sensation when moving the shoulder. If the tear happens suddenly, as with an acute injury, you may feel a snapping sensation followed by intense pain and weakness. Tears that develop slowly over time may cause pain that is mild at first, but gradually increases over time.

Rotator Cuff Surgery

If you are very active, have a large tear, or nonsurgical treatment options like rest, anti-inflammatory medications, and physical therapy do not help, surgery is often recommended. Depending on the severity of the tear, there are a few different surgical methods that may be used to repair the rotator cuff: an open repair, an all-arthroscopic repair, or a mini-open repair.

Open Repairs

An open repair may be necessary if the tear is very large or complex. During an open repair, your surgeon will make an incision over the shoulder and detach the deltoid muscle to access the torn rotator cuff tendon and repair it. If any bone spurs are present, they may be removed during the procedure. An open repair is the most traditional way to repair a torn rotator cuff.

All-Arthroscopic Repairs

Advancements in technology and surgical experience have paved the way for arthroscopic rotator cuff repairs. During an all-arthroscopic repair, your surgeon makes a small incision to insert a small camera called an arthroscope into the shoulder joint. The camera displays images from within the shoulder on a monitor in the operating room. This allows him to view the structures within the shoulder and make the repair through a much smaller incision than is needed for an open repair. Additional minor incisions are used to insert small operating instruments to complete the procedure. Because the incisions are smaller, arthroscopic surgery is less invasive than open surgery; it often results in less pain after surgery, less blood loss, and a quicker recovery time.

Mini-Open Repairs

Mini-open repairs use a combination of arthroscopy and open surgery to repair the rotator cuff. First, arthroscopy is used to assess the damage to the rotator cuff and to treat any other damage present in the joint, such as bone spurs. Then, the surgeon views the shoulder directly through a small incision to repair the rotator cuff.

Recovery

Following surgery, your arm will need to be immobilized in a sling for the first four to six weeks while the tendon heals. Once your doctor feels that it is safe for you to begin moving your arm, you will begin physical therapy with passive exercises designed to improve the range of motion in your shoulder. As your recovery progresses, you will move on to active exercises and strengthening exercises.

Full recovery can take several months, but it is important to follow all post-operative instructions given to you by your surgeon for the best result.

Rotator Cuff Surgery in Beaumont, TX

We strive to provide the best orthopaedic care possible. Our board-certified, fellowship-trained orthopaedic surgeons specialize in a wide variety of orthopaedic procedures, including rotator cuff surgery. To learn more about rotator cuff surgery or schedule an appointment with one of our surgeons, you can reach our Beaumont office at (409) 838-0346 or our Port Arthur office at (409) 729-5633.