Shoulder joint is protected by a group of muscles and tendons which are called as Rotator cuff. They cover the shoulder like a cuff which helps you to lift and rotate your arms smoothly. These tendons can be torn or get pinched by the bones around them due to severe falling on your arms or injury and overuse. Rotator cuff tear can be a very painful condition and hindering in your normal functioning of shoulder joint.
Rotator cuff repair is the surgical repair of torn tendons and can be done either as an open procedure or via shoulder Arthroscopy. Surgery can relieve your pain and restore function to your shoulder.
PREPARING FOR THE SURGERY
If your shoulder pain due to rotator cuff tear is not subsiding or improving through medications and physiotherapy, your doctor will advise you to undergo rotator cuff repair surgery. Generally, rotator cuff repair surgery is done on an outpatient basis but if the tear is major, you may require a hospital stay. Nowadays, shoulder Arthroscopy is commonly done to repair rotator cuff, however, in case of large or complex tear, open shoulder repair is done.
Before the surgery, you will have to undergo a thorough physical examination, blood tests and other diagnostic tests like X-ray. This is done to have detailed study of the torn tendons and its complexity which will determine what type of repair surgery you will have to undergo. You may be asked to stop certain medications or supplements you are taking before the surgery. If you have diabetes, heart disease, or other medical conditions, you will be first referred to those specialists to control any major issues which may lead to complications after rotator cuff repair surgery.
ON THE DAY OF THE SURGERY
Both the types of rotator cuff repair surgery are done under general anaesthesia, means you will be asleep during the procedure. Sometimes it is also done under regional anaesthesia along with relaxing medications which will make your shoulder region numb and you will feel sleepy.
During shoulder Arthroscopy, 2-3 small incisions are made and through one of them an Arthroscope (camera) is inserted which is on other end is connected to the video monitor and allows the surgeon to view the inside of shoulder. Through rest of the incisions, other surgical instruments are inserted which assist in repair. During open repair, a large surgical incision is made and the shoulder muscles (deltoid) is gently moved out of the way to do the surgery.
After the incisions are made, to repair the rotator cuff the tendons are re-attached to the bone. Small sutures (stitches) are made in the form of anchor to attach the tendon to the bone. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. At the end of the surgery, the incisions are closed, and a dressing is applied. If arthroscopy was performed, most surgeons take pictures of the procedure from the video monitor to show you what they found and the repairs that were made.
After the surgery, you will be monitored in the recovery room and once you are alert and your vital signs are normal, you may be discharged the same day of the surgery. But, if you had an open repair you would require a hospital stay of 1-2 days. You would feel mild to moderate pain after the surgery which can be managed by medications. You will be instructed about the exercises you need to perform in order to regain the strength and motion of your shoulder. A sling or shoulder immobilizer will be given to you to wear to keep your shoulder from moving.
Recovery after and arthroscopic rotator cuff repair surgery is bit quicker than the open shoulder repair. However, no matter which type of surgery you underwent, it will take around four to six months to recover completely. Physical therapy will be a key part of your recovery and you will be instructed to keep the shoulder as immobile as possible and to keep your arm in a sling. The use of the sling keeps the weight of your arm off of the tendon which assists in the healing process. Most people don’t get instant pain relief from surgery. It may take a few months before your shoulder starts feeling better. Till then the pain will be managed by medicines.
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Q: When do I need a Rotator cuff repair surgery?
A: When the muscles and tendons in your shoulder are completely torn following a severe injury, you will be advised for surgery.
Q: How long will I have to wear sling?
A: You should expect wearing sling or shoulder mobilizer for six weeks post-surgery.
Q: How will I know if I have a rotator cuff tear?
A: Rotator cuff tear causes an unbearable pain in shoulder area making it difficult for you to move or lift your arms and you can’t even sleep on the affected side.
Q: What is the average recovery time after rotator cuff repair surgery?
A: It can take about 4 to 6 months to recover after the surgery, also it depends on type of surgery and other health factors.
Q: How can I sleep after rotator cuff repair surgery?
A: You should sleep in a reclined position and on the opposite side of the operated shoulder and put your injured arm on a pillow to avoid pressure.
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