Rotator cuff repair is the surgery performed to repair the tendon that is torn in the shoulder. The procedure of the surgery requires an open or large incision to be done or also with shoulder arthroscopy, which needs only a buttonhole-sized incision.
A rotator cuff is present at the joint of shoulder. It is a group of tendons and muscles and forms a cuff on the joint of the shoulder. These tendons and muscles are used to hold the arm tight with its joint and enable the joint of the shoulder to move. This tendon can possibly torn from injuries or overuse.
Need for Repair
- Severe shoulder pain during the nights, while in rest and the pain is not relieved from the exercises continuously for at least 6 to 12 months duration
- When the shoulder is over used for harder works or sports, etc.
- The candidate becomes weak and cannot perform day to day activities
So, surgery is needed to be performed, when rotator cuff tears completely, tear because of the injury or chronic rotator cuff problems.
Procedure starts with the general anesthesia given to the patient and the patient asleep during the surgery. Alternately, regional anesthesia is also given to numb the shoulder and surrounding area with additional medicine for sleeping.
Repair is done for various conditions in various ways.
- Mini Open Repair
- Open Repair
During the procedure of the mini open repair, the tissues or bone spurs that are damaged would be removed with the help of arthroscope and sometimes removed, based on the need. Then a small incision of about 2 to 3 inches of incision is made for repairing the rotator cuff.
In the open repair of the rotator cuffs, larger surgical incision is made. Then the large muscle present in the shoulder is moved from the way to perform the surgery. This repair is usually needed for the complex and larger tears.
During the arthroscopy procedure, a small arthroscope or the camera is inserted into the shoulder through smaller incisions. Then the scope is connected with a screen or monitor to watch the video. The surgeon watches the video to understand the position of the bones, etc., inside the shoulder. Accordingly, the repair is performed with the help of the other instruments by making other smaller incisions. The internal positions of the bones and tendons along with the repairs that are performed, can be recorded with the pictures and then can shown to the patient.
For any of the above procedure, the rotator cuff is repaired and the tendons are made re-attached to its bone. The attachment is performed using small rivets, which are also called as suture anchors. These suture anchors are usually made from the material that would be dissolved over certain time, so these are not required to be removed. Finally, sutures will be attached to these anchors and tendons are tied back to the bone.
After the surgery is performed, the small or larger incisions that were made are closed and over the cover, dressing will be applied.
Usual risks associated with the anesthesia are breathing problems and allergic reactions caused from the medicine.
Risks associated with the rotator cuff surgery are infection, bleeding or injury to nerves or blood vessels.
Surgery gives poorer results, usually, when the rotator cuff was readily weak or was torn, before the injury occurred, presence of larger tears, when instructions, exercises are not followed after the surgery, smoking and for the older patients.
Usually after the rotator cuff repair, the shoulder pain would be relieved. Return of the shoulder strength requires longer period of time, especially, when the larger tear is treated. A few months are required to get back to the regular and normal activities.
Cost of Rotator Cuff Repair Surgery
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