A rotator cuff repair surgery is a surgical procedure that is used to re-attach a torn tendon in the shoulder joint to restore the shoulder’s movement and functions. This is done by stitching the torn tendon in the shoulder back to the upper arm bone (humerus).
The tendon may be partially torn and would usually require a trimming or a smoothing procedure known as ‘debridement’. In case the tendon gets completely torn in the thickest part the repair is done by stitching the torn portions together with sutures.
A surgical repair for a rotator cuff injury is required when:
The commonly seen signs and symptoms of a rotator cuff injury are:
A rotator cuff may get injured due to a significant injury to the shoulder or as a result of progressive wear and tear of the tendon tissue in the shoulder.
Repetitive movements involving raising the arms overhead for heavy lifting or prolonged periods of time can also lead to tendon degeneration in the shoulders.
At times the development of bone spurs (abnormal bone growth) around the bones in the shoulder is also likely to damage the shoulder tendon in the rotator cuff.
The primary diagnostic test is usually a physical examination of the shoulder joint where the doctor will try to determine the location of the pain as well as see for restrictions in the arm movement. The doctor will also test the strength in the shoulder and arm muscles.
Advanced diagnostic techniques for determining a torn tendon (rotator cuff) injury are:
X-rays – This can help determine the presence of bone spurs in the shoulder, or signs of arthritis which might be causing the pain in the shoulder.
Ultrasound – This test can provide a better view of the muscles and tendons to check for tears or other abnormalities in the soft tissue structures.
MRI (magnetic resonance imaging) – This is used to obtain an image of the complete shoulder structure in explicit detail and helps determine the location and the severity of the tear in the rotator cuff.
There are various alternative methods to treat a rotator cuff injury if it is mild in nature. These are some of the non-surgical treatment methods for a rotator cuff injury:
In case you suffer from a shoulder injury that is consistently aching with a dull pain for 2-3 days you need to put an ice pack and give the shoulder complete rest for at least 3-4 days. If the injury is mild in nature you will see an improvement in motion range and shoulder strength as well as decrease in the pain.
If an ice pack and rest for a few days does not relieve the symptoms of an injured shoulder then the doctor might recommend a steroid injection to the shoulder joint. Such steroid shots are recommended if the intensity of the pain is giving you sleepless nights or interfering with your daily activities or exercise.
These shots need to be regulated as excessive steroid injections can weaken the tendon as well.
Physical therapy methods are useful to improve motion range, strength and flexibility after a rotator cuff injury. This may also help in restoring the function in the shoulder as well as reduce pain.
A rotator cuff injury usually needs surgical treatment if it is severely disabling in nature and caused by a traumatic injury or if a previously mild case of rotator cuff injury has failed to respond satisfactorily to other alternative methods (physical therapy, etc).
The doctor/surgeon will recommend a surgical method for treatment after taking into consideration several factors such as the severity and size of the tear, your individual body structure and the quality of the bone and the tendon tissue.
In case you have other additional problems in the shoulder besides the injured rotator cuff tendon, such as bone spurs, osteoarthritis or other tissue damage, the surgeon will treat these as well.
There are three common rotator cuff repair surgical procedures and all have been found satisfactory in the end with alleviated pain, improved function as well as added strength in the injured shoulder.
These are the three techniques that are used to perform a rotator cuff surgical repair:
This is the conventional open-type surgery in which the surgeon uses normal incisions over the shoulder joint and detaches the deltoid (shoulder) muscle to get a better view to the damaged tendon.
The surgeon will also remove bone spurs (abnormal bone growths) from the shoulder joint with an acrominoplasty procedure. An open repair surgical technique is highly recommended when the tear in the tendon is large or complex in nature. It is also recommended in case there is a need for additional reconstruction required, such as a tendon transfer to replace a severely damaged tendon.
This is a minimally invasive surgical technique and uses a thin flexible tube with a light and video camera attached to its end, called an arthroscope. The surgeon needs to make very small (keyhole) incisions to insert the arthroscope into the shoulder joint to get a better view of the joint on a video monitor. This enlarged image enables the surgeon to insert similar arthroscope with tiny surgical instruments attached to perform the required repair procedure.
The number of incisions and their size is far lesser than that required for an open repair surgery and this minimally invasive surgery is performed as an outpatient procedure.
This is also a type of minimally invasive surgical procedure that uses a combination of arthroscopy and conventional surgery.
This procedure begins with the surgeon making a small (3-5 cms long) incision over the shoulder. This incision is used to insert the arthroscope to see the extent of the damage to the joint components. The arthroscope will also be used to remove any bone spurs thus having to avoid detaching the deltoid (shoulder) muscle.
The surgeon will use the same incision to repair the rotator cuff injuries through the same incision once the arthroscopic procedure is completed. The tendon repair is done with the surgeon seeing the shoulder structures directly rather than a video monitor from an arthroscope.
There may be slight discomfort immediately after a rotator cuff repair surgery and the doctor will recommend the required painkiller for you. The repaired arm will be put in a sling for around 1-2 weeks.
The doctor usually instructs you for a session of physical therapy for a successful recovery.
The rehabilitation program will involve:
IndianMedTrip is one of the frontrunners in managing all kinds of rotator cuff repair treatment in India with connections to the best and most cost affordable orthopedic hospitals and clinics in all major Indian cities such as Mumbai, Delhi, Bangalore, Pune, etc. IndianMedTrip is associated with a large number of extensively-experienced and intensely-trained orthopedic specialists and surgeons. IndianMedTrip aims to provide a comfortable and efficient treatment for rotator cuff injuries in India at the lowest cost.