Rotator Cuff Repair

Treatment of rotator cuff injury varies significantly and depends upon the severity of the injury. In some cases, the patient may get relief from resting the affected arm. In other cases, surgery is required. The method of treatment is selected based on the degree of tear in the rotator cuff. Non-surgical treatment generally relieves the condition in about 80% of people. 

Non-surgical methods are:-

1. Physical therapy
2. Hot or cold packs placed over the affected area may help to relieve the pain
3. Exercise is advised to restore the strength of the arm
4. Resting the affected arm 
5. The patient is advised to wear a sling to restrict the motion of the arms
6. Pain killers (NSAIDs) are also given to the patient to reduce the pain
7. Steroidal injections may also provide relief from pain and inflammation.

Surgical methods to treat rotator cuff injury are:-

1. Open: The doctor uses large instruments to go into the muscles and fix the tear.
2. Arthroscopic: A small cut is made in the shoulder, and a tube with a small camera on its head is used to fix the tear. Recovery time in this method is very short compared to any other method.
3. Mini-open: In this process, both open and arthroscopic approaches are used. 
4. Shoulder replacement: If the tear is large and it is not easy to heal it with the above-listed methods, this method is used. In this method, your shoulder joints need to be replaced.
5. Tendon transfer: In some cases, the tendon detached from the bone and the doctor reattaches it to the bone during surgery. However, if the tendon is badly damaged, the surgeon transfers the tendon from a different site to the site of injury. This process is known as tendon transfer.

Your doctor will only advise the surgery when the tear is large or if its symptoms last for six months to 12 months.

What to expect before rotator cuff surgery?

1. Your doctor and anaesthesia team will review your medical history. They will ask you about your concerns regarding the procedure. 
2. The doctors may interact with you and inform you about the pre-surgical instructions.
3. The patient is asked to discontinue some specific medicines two weeks before surgery. Especially medicines that delay the blood clotting procedure.
4. The doctor may ask the patient to meet a physical therapist for rehabilitation.
5. Try to get the maximum rest on the night before surgery.
6. It is also recommended to solve the other arm and shoulder skin problems before shoulder surgery.

What to expect on the day of rotator cuff Surgery?

1. You may expect the following on the day of rotator cuff surgery:
2. You must visit the hospital at least two hours before the scheduled time provided by the hospital. It will help you to feel comfortable.
3. Do not take any jewellery, watch or other valuable items.
4. You should bring a relative or friend to complete the formalities in the hospital. It includes filling out the informed consent form and paying the surgery fees.
5. Wear loose clothes and bring non-slippery footwear.
6. The staff will advise you to change your clothes and wear a gown.
7. The doctor may also allow you to take routine medicines. However, you should take them only with a few sips of water.
8. The staff will check your vital parameters, such as blood pressure, heart rate, and respiratory rate.
9. You will then be shifted to the operation theatre for surgery.

What to expect during surgery?

1.  Most rotator cuff surgery takes place as an outpatient procedure. 
2. The doctor will administer either general or regional anaesthesia.
3. The doctor makes a small incision in the shoulder. 
4. The doctor inserts an Arthroscope (a small tube fitted with a camera) through the incision to guide the surgeon in performing surgery.
5. Then surgeons insert a tiny instrument into the shoulder and fix the shoulder bones and tendons. 
6. Then the incision is closed using a suture. Usually, dissolving sutures are used.

1. After completing the surgery, the patient is advised to wear a sling. This sling is recommended to immobilise the affected arm of the patient.
2. The affected arm is immobilised for four to six weeks.
3. After removing the sling, the patient can start the sessions of physical therapy.
4. In most cases, the shoulder functions are regained after four to six months of the surgery.
5. But still, you should avoid doing heavy work because it may take around twelve to eighteen months to fully recover from the injury.

First follow-up appointment

1. The first follow-up appointment after surgery is to make sure whether the patient is doing well or not. 
2. The doctor will examine the shoulder. He will check for recovery whether the shoulder is accurate or not. 
3. The doctor may also remove the stitches if non-dissolving stitches are used. 
4. The doctor may change some medications, especially pain killers, because the pain killers that are prescribed after surgery are too strong and need to be changed to milder pain relievers.

You should immediately consult a doctor if you have started experiencing any of the following signs and symptoms. 

1. Severe pain is not improving with ice, rest, and pain relievers.
2. If you feel a tearing sensation and cannot lift your arm.
3. If your arm is feeling weak right after some injury.
4. If the pain worsens at night and has started interfering with your sleep.
5. If there is swelling, redness, and tenderness in your arm.