Arthroscopic Rotator Cuff Repair
The rotator cuff is the thick band of muscles and associated tendons that cover the top of the upper arm and hold in it place, providing support and stability to the shoulder joint. The rotator cuff also allows for a full range of motion while keeping the ball of the arm bone in the shoulder socket. These tendons can become partially or completely torn as a result of a rotator cuff tear or injury. A rotator cuff tear often occurs as a result of injury or overuse of the muscles over a long period of time. Rotator cuff tears typically involve pain when lifting or lowering the arm, muscle weakness and atrophy, and discomfort at rest, particularly if pressure is placed on the affected shoulder.
In most cases, surgery is recommended for tears that cause severe pain or that do not respond to more conservative treatments. Most rotator cuff repair procedures are performed through arthroscopy, which uses a few tiny incisions rather than one large incision. This technique offers patients minimal trauma, less scarring and less damage to the surrounding muscles and tissue. The smaller incisions also result in less pain in the shoulder joint after the surgery.
Arthroscopic Rotator Cuff Repair Procedure
The purpose of arthroscopic rotator cuff repair is to attach the tendon back to the arm, along with removing any loose fragments from the shoulder area. Arthroscopy is a minimally invasive surgical technique that involves making several small incisions and inserting a fiber-optic device (arthroscope) and tiny surgical instruments to diagnose or treat certain conditions. Connected to a camera that displays images of the internal structure of the shoulder on a computer screen, the arthroscope allows the surgeon to precisely identify, target and treat joint abnormalities.
During arthroscopic rotator cuff repair, the patient is sedated under general anesthesia, and several small incisions are made in the shoulder, into which a thin tube and tiny instruments are inserted. The surgeon repairs the tendon through visualization on a television monitor. During the surgery, rotator cuff tears are repaired and any bone spurs are removed. The rotator cuff muscle is stitched back to the bone, which helps the rotator cuff to heal in its proper location. Once the repair is complete, any incisions will be stitched closed and patients will be moved to a recovery room where they will be monitored post-operatively for a few hours.
Risks of Arthroscopic Rotator Cuff Repair
As with any surgery, there are certain risks involved with arthroscopic rotator cuff repair, which may include:
- Infection
- Pain
- Stiffness
- Nerve damage
- Need for repeated surgery
These complications are rare and most people experience symptom relief with little to no complications after arthroscopic rotator cuff repair
Recovery from Arthroscopic Rotator Cuff Repair
After surgery, the arm is immobilized to promote proper healing. A sling may be recommended to keep the arm from moving for the first several weeks post-surgery. Physical therapy often begins shortly after surgery to help restore strength and movement and allow patients to gradually resume their regular activities. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results.
Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results. After surgery, physical therapy may be necessary for up to 4 months and full recovery may take up to 6 months. Most patients experience effective pain relief, restoration of function and improved range of motion after their procedure.
Rehabilitation for Rotator Cuff Injury
The rotator cuff is the thick band of muscles and associated tendons that cover the top of the upper arm and hold in it place, providing support and stability to the shoulder joint. The rotator cuff also allows for a full range of motion while keeping the ball of the arm bone in the shoulder socket. These tendons can become partially or completely torn as a result of a rotator cuff tear or injury. A rotator cuff tear often occurs as a result of overuse of the muscles over a long period of time. This condition is more common in individuals over the age of 40 as well as in athletes or those who practice repetitive lifting or arm movement in their occupation. A rotator cuff injury may also occur as a result of a traumatic injury.
Treatment varies and may include conservative treatments such as rest, ice and physical therapy, while severe cases may require surgery for repair. Although the methods used to treat rotary cuff injuries may vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the arm and shoulder and help the patient return to all usual activities.
Nonsurgical Rehabilitation for Rotator Cuff Injury
In some cases, rotator cuff tears can be treated through nonsurgical methods that focus on relieving pain and restoring function to the shoulder. These may include rest, use of a sling, anti-inflammatory medication, steroid injections and physical therapy. Physical therapy exercises focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade. Treatment may include:
- Muscle strengthening exercises
- Gradual weight-bearing activities
- Range of motion exercises
The physical therapist may also make suggestions and create exercises for improving posture and shoulder alignment.
Rehabilitation After Rotator Cuff Surgery
In most cases, surgery will be recommended for tears that cause severe pain or that do not respond to more conservative treatments. The type of surgery performed depends on the size and location of the tear, but often involves trimming torn edges or suturing the tendon back together. Physical therapy often begins shortly after surgery to help restore strength and movement and allow patients to gradually resume their regular activities. Initial physical therapy treatments may include ice, electrical stimulation and massage, to help control pain and swelling. As the healing begins, muscle-stengthening exercises and range of motion exercises may be used to increase movement and mobility.
Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results. After surgery, physical therapy may be necessary for up to 4 months and full recovery may take up to 6 months.