Rotator Cuff Surgery

What surgery is used for rotator cuff repair?

Common rotator cuff corrective surgeries that Midwest Orthopaedics at Rush (MOR) physicians have extensive experience performing include arthroscopic repair surgery. MOR physicians excel at performing innovative arthroscopic procedures that use minimally invasive approaches to treat rotator cuff tears. Because arthroscopic surgery requires a smaller access point, the incisions are much smaller than in traditional open surgery, leading to shorter recovery time for the patient. Smaller incisions also create less trauma to the deltoid muscle, resulting in reduced post-operative pain and improved function. Arthroscopic surgery is almost always successful in alleviating pain in the rotator cuff and most patients regain strength in their arms and shoulders.

If the tear is too large or the condition is too complex, the surgeon may do an open surgical procedure. Open repair was the first technique used for torn rotator cuffs. Over the years, new technology and improved surgeon experience led to less invasive procedures. These arthroscopic, minimally invasive techniques allow the surgeon to visualize and access the pathology in the shoulder. The rotator cuff tendons can be repaired with arthroscopic techniques, and associated pathology and conditions addressed at the same time. The vast majority of rotator cuff problems can be addressed in this minimally invasive fashion.

Occasionally, open surgery might be required if there is additional reconstruction needed, such as a tendon transfer due to the complexity of the rotator cuff problem. The surgeons at MOR make an incision over the shoulder and detach the muscle (deltoid) to better see and gain access to the torn tendon.

During an open repair, the surgeon can also remove any bone spurs from the underside of the acromion (this procedure is called an acromioplasty).

Rotator cuff surgery can be a complex procedure. Success comes from a skilled orthopedic surgeon specifically trained in arthroscopic shoulder surgery in conjunction with a dedicated team of anesthesia doctors. Patients who work with a MOR physician have the advantage of a highly trained and experienced shoulder specialist who employs the most advanced technologies.

What is the recovery for rotator cuff surgery?

Immediately post-surgery, the patient's arm is put in a sling, ice is applied for pain and they are encouraged to walk. The sling can be loosened to allow the elbow to straighten, but the shoulder should remain immobile. Those patients undergoing arthroscopic surgery typically go home the same day as the surgery. Immobilization through the sling continues for three to four weeks, allowing the tendon to heal. Patients should not lift their arms on their own for the first four to six weeks after surgery.

Physical therapy plays a critical role in the recovery process as the patient works to restore range of motion. Most patients will begin physical therapy sessions before they leave the hospital. It's very important to get some range of motion back to the shoulder to avoid the shoulder becoming too stiff.

After surgery, the staff at Midwest Orthopaedics at Rush works with patients to find a physical therapy team skilled in shoulder therapy. Four weeks after surgery, a rotator cuff patient should be able to lift the arm with the assistance of a therapist. By three months, patients can lift the arm and begin more aggressive strengthening exercises. By six months after surgery, most patients have regained 80 percent of their strength and are actively playing sports and working. It is important to continue physical therapy at this stage. Studies show that over the next two years, increased strength will continue with the aid of physical therapy.