Definition
Definition
The rotator cuff is a group of 4 muscles in the shoulder and upper arm. The muscles help to move the arm at the shoulder and to stabilize the joint. The muscles are connected to the shoulder bone by tendons, which are strong, flexible cords. The muscles or tendons may become damaged from long term overuse or from injury.
Rotator Cuff TearCopyright © Nucleus Medical Media, Inc.
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Reasons for Procedure
Reasons for Procedure
Your doctor may recommend this procedure for:
- A rotator cuff injury that does not respond to rest and physical therapy treatment
- A complete tear in the tendon
- Chronic pain and weakness from a partial tear in the tendon
Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Infection
- Excess bleeding
- Blood clots
- Reaction to anesthesia
- Weakness or numbness in shoulder joint
- Detachment of the shoulder muscle
- The operation does not improve function
Factors that may increase the risk of complications include:
- Smoking
- Alcohol abuse
- Obesity
- Diabetes or other chronic disease
What to Expect
What to Expect
Prior to Procedure
Your doctor may do the following:
Before this procedure, you will need to:
- Arrange for help at home while you recover
- Talk to your doctor about any medications, herbs, or supplements you are taking
- Talk to your doctor about any allergies you have
- Ask your doctor about assisted devices you will need
- Arrange for someone to drive you home after the procedure
You may need to stop taking some medications up to 1 week before the procedure.
Do not eat or drink anything after midnight the day before your procedure, unless told otherwise by your doctor.
Anesthesia
General anesthesia is typically used. You will be asleep during the procedure.
Description of Procedure
There are 2 methods used to perform a rotator cuff repair:
Open Surgery
A cut will be made in the skin over the shoulder. The torn muscle or tendon will be repaired and reattached and/or anchored with stitches. The incision will then be closed with stitches or staples.
Arthroscopic Surgery
A few small incisions will be made in the shoulder. A narrow tool called an arthroscope will be inserted through the incision. The scope has a tiny camera to allow the doctor to see inside. Other small instruments will be inserted through the other incisions. These tools will be used to repair the tendon or muscle.
After either procedure, the incisions will be bandaged. Your arm will be placed in a sling or brace to immobilize the joint.
How Long Will It Take?
About 1½ to 2 hours
How Much Will It Hurt?
Anesthesia prevents pain during the procedure. You may have some discomfort immediately after. Ask your doctor about medication to help with the pain.
Average Hospital Stay
You may be able to go home the same day. Some may need to stay in the hospital overnight.
Post-procedure Care
At the Care Center
Right after the procedure, you may be given medication, such as:
- Pain medication
- Antibiotics to prevent infection
- Medication that prevents blood clots
At Home
When you return home, take these steps:
- Do not use the arm until instructed. Wear the sling or brace as directed.
- Follow instructions for physical therapy. Therapy is essential to regain shoulder strength and range of motion.
- Be sure to follow your doctor’s instructions.
The rotator cuff will take several months to heal. It may take some time before you can raise your arm above your shoulder. It may be up to one year before you can hold your arm above your head and do work with reasonable strength. An aggressive and consistent physical therapy and exercise program is the key to a faster recovery.
Call Your Doctor
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
- Pain that cannot be controlled with the medications you were given
- Nausea or vomiting
- Cough, shortness of breath, or chest pain
- The stitches or staples come apart
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
American College of Sports Medicine http://acsm.org
CANADIAN RESOURCES:
Public Health Agency of Canada http://www.phac-aspc.gc.ca
References:
http://www.acsm.org/docs/current-comments/exandshoulderpaintemp.pdf
Accessed February 27, 2015.
Rotator cuff repair. John Hopkins Medicine website. Available at:
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/rotator_cuff_repair_92,P07682/
Accessed February 27, 2015.
Rotator cuff surgery discharge instructions. John Hopkins Medicine website. Available at:
http://www.hopkinsortho.org/orthopedicsurgery/RotatorCuffDischarge.pdf
Published May 7, 2010. Accessed February 27, 2015.
Rotator cuff tear. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated December 15, 2014. Accessed February 27, 2015.
Rotator cuff tears: surgical treatment options. American Academy of Orothopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00406
Updated May 2011. Accessed February 27, 2015.
6/2/2011 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last Updated: 2/26/2014