FAQs on Arthroscopic Rotator Cuff Repair
The last two decades have witnessed an increasing shift from open surgery to arthroscopic rotator cuff repair. Faster recovery and fewer complications have led to a 600 percent jump in rotator cuff arthroscopy in the last 10 years. Patients are moving from inpatient to this outpatient surgery that restores optimal shoulder function with minimal invasive procedure.
What is arthroscopic rotator cuff repair?
Arthroscopic rotator cuff repair is one of the several methods used to surgically repair tears in the rotator cuff muscles and tendons. In contrast to open surgery, the arthroscopic procedure is carried with the help of a tiny fiber-optic camera called arthroscope, which is inserted through a small incision on the shoulder. Live video images generated by the camera guide surgical repairing of tears in the rotator cuff muscles and tendons using specialized instruments inserted through several small punctures.
The process aims at removing damaged tissues, inflamed bursa, and bone spurs, relieving pressure on the tendons, stitching up tears, and creating enlarged space for the rotator cuff movement. Minimally invasive, it leads to swift and fast recovery without scarring, larger incisions, and major complications. The arthroscopic rotator cuff repair is capable of restoring full structural and functional flexibility of your shoulder.
What is rotator cuff injury?
Rotator cuff provides stability to shoulder by holding the ball-shaped head of the upper arm in the shoulder socket. When tears appear in any of its four muscles and their tendons, these parts become inflamed and fail to provide full-strength support to the humeral head. We feel pain and shoulder weakness. The condition is known as rotator cuff injury.
Degeneration, traumatic injury, excessive stress, or repetitive overhead activity may lead to partial or complete tear in rotator cuff.
Who is a candidate for arthroscopic rotator cuff repair?
You are a fit candidate for arthroscopic rotator cuff repair if
- injury is the result of sudden trauma
- pain continues despite nonsurgical treatments
- pain symptoms persists for more than 6 months
- tests show large rotator cuff tear or irrecoverable damage
- the injury is causing significant shoulder weakness and function loss
How is arthroscopic rotator cuff repair performed?
Patient is put on a beach chair or in side-lying position and placed under general anesthesia. A tiny incision is made on the shoulder to insert the tube-shaped arthroscope camera. Video images relayed by the camera help assess the damaged area and the condition of the bursa and surrounding structures. Smaller incisions on the shoulder front, side, and back is made and miniature instruments are placed inside for the surgery.
The surgery is carried out according to the need. It may include debridement or smoothing, restructuring tendon attachments, or stitching the tears using specially-designed suture anchors.
Surgeons may trim the acromion, remove coraco-acromial ligament, or spruce acromioclavicular joint depending on the cause and need for rotator cuff repair.
How long does arthroscopic rotator cuff repair surgery take?
The entire process takes 1 to 2 hours subject to complexity of the tear and patient condition.
Do I need to stay at the hospital after arthroscopic rotator cuff repair?
No. You are discharged with 3 to 4 hours of the surgery. However, development of surgical complications during the observation period may cause you to extend the stay for a few hours or a day.
Do I need rest after arthroscopic rotator cuff repair?
Yes, but for a few days, most often 1 to 2 days. You may be required to use an immobilizer or sling for three to five weeks depending on tear size. Use a pain medication to prevent shoulder soreness bothering you. Applying ice packs also helps. Keep the dressing for at least three days and do not have shower till then. Visit your doctor after a week.
What are the restrictions following arthroscopic rotator cuff repair?
- No shower for 72 hours
- Use sling for four to six weeks all the time except for prescribed exercises and sedentary activities
- Keep the operated area dry and clean
- No lifting or rotating of the arm
- Activity level subject to comfort and level of tolerance
- Gentle stretching of hand is allowed
- No push or pull activity until six weeks
- No driving for at least four weeks
- No sports activities for six months
What kind of rehabilitation is needed following arthroscopic rotator cuff repair?
Doctors may suggest to start gentle pendulum exercises on the second day of surgery. You can commence passive exercise next day under supervision. Usually the rotator cuff muscles take six weeks to gain strength and you can start active exercises only after that.
Practice passive exercises for three to four times a day until six weeks. From seventh week onward, you can start formal active physiotherapy and continue for four-five months. Start strengthening exercise after the 12th week to improve shoulder strength and mobility.
How long is the recovery period following arthroscopic rotator cuff repair?
Completely recovery takes several months. The limited recovery occurs within six weeks and you can perform all normal activities. It takes 12 to 16 weeks to perform limited athletics. However, you need at least four to six months for a full return to the original rotator cuff strength.
What are the potential complications of arthroscopic rotator cuff repair?
- Risks of anesthesia allergic reaction
- Bleeding, nerve injury, rupture of structures around, infection, and similar avoidable surgical complications.
- Temporary pain and stiffness in the shoulder
What are benefits of arthroscopic rotator cuff repair over open surgery?
The procedure is highly effective and minimally invasive. No longer hospital stay or fear of complications or extensive rehabilitation or too much restricted precautions. Patients can successfully regain their shoulder strength within six months.
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