Like any machine, the human body can handle plenty of wear and tear throughout a person’s life, but certain areas may eventually break down over time. One particular area that tends to wear out is the rotator cuff area of the shoulder, especially if the individual participates in an activity or occupation with repetitive motions such as baseball pitchers, weight lifters, or tennis players, painters, and carpenters.
The shoulder is a ball-and-socket joint and fits into a shallow socket in your shoulder blade. To ensure the shoulder stays in the socket, a group of four muscles called the rotator cuff come together as tendons and form a covering around the head of the humerus (one of the three bones which make up your shoulder). The rotator cuff allows you to be able to lift and rotate your arm.
After an injury such as a fall or due to damage over time, the lubricating sac (bursa) between the rotator cuff and the bone on top of the shoulder can become inflamed and be quite painful. When the rotator cuff tendons are torn (usually beginning as fraying), raising your arm and lifting objects will become difficult and next to impossible over time. If the tendon is damaged but not completely severed, it is called a partial tear; when the tendon is completely separated from the bone, that is known as a full-thickness (or complete) tear, which creates a hole in the tendon.
Whether it is an acute tear caused by an injury such as a fall or lifting something with a jerking motion or a degenerative tear resulting from the tendon's wearing down over time, damage to the rotator cuff needs to be examined and addressed by an experienced bone and joint specialist.
What you need to know about Rotator Cuff Repair Surgery:
The shoulder is a ball-and-socket joint and fits into a shallow socket in your shoulder blade. To ensure the shoulder stays in the socket, a group of four muscles called the rotator cuff come together as tendons and form a covering around the head of the humerus (one of the three bones which make up your shoulder). The rotator cuff allows you to be able to lift and rotate your arm.
After an injury such as a fall or due to damage over time, the lubricating sac (bursa) between the rotator cuff and the bone on top of the shoulder can become inflamed and be quite painful. When the rotator cuff tendons are torn (usually beginning as fraying), raising your arm and lifting objects will become difficult and next to impossible over time. If the tendon is damaged but not completely severed, it is called a partial tear; when the tendon is completely separated from the bone, that is known as a full-thickness (or complete) tear, which creates a hole in the tendon.
Whether it is an acute tear caused by an injury such as a fall or lifting something with a jerking motion or a degenerative tear resulting from the tendon's wearing down over time, damage to the rotator cuff needs to be examined and addressed by an experienced bone and joint specialist.
What you need to know about Rotator Cuff Repair Surgery:
- Rotator Cuff Repair vs. Shoulder Replacement
- Types of Rotator Cuff Tear Repair Options
- Open Rotator Cuff Repair
- Arthroscopic Rotator Cuff Repair
- Double Row Rotator Cuff Repair
- Acromioplasty Rotator Cuff Repair
- Arthrex Rotator Cuff
- Rotator Cuff Repair with Biceps Tenodesis
- How Long Is the Surgery for Rotator Cuff Repair
- Rotator Cuff Repair Recovery Time
- Exercises after Rotator Cuff Repair Surgery
Rotator Cuff Repair vs Shoulder Replacement
When the rotator cuff has been injured, and the typical, non-surgical treatment methods have not successfully alleviated the pain, our bone and joint specialists will likely recommend surgery. Other indications that you may be a good candidate for rotator cuff surgery include:
This type of surgery often involves reattaching the tendon to the head of the humerus, and there are a few surgical options that we will discuss with you.
For shoulder replacement surgery, the damage is to the shoulder bones or joints rather than the tendons. Our surgeons will replace the damaged bone and put in prosthetics to restore shoulder function. There are two types of shoulder replacement surgeries: conventional and reverse. Traditional shoulder replacement involves replacing the shoulder socket with a plastic cup and metal ball on the upper arm bone.
It requires that the rotator cuff is functioning correctly. Suppose a patient is suffering from a massive rotator cuff tear or shoulder arthritis (arthropathy). In that case, our surgeons may recommend the reverse total shoulder replacement because it does not require the rotator cuff for it to be effective. Instead, it relies on the deltoid muscle. The reverse shoulder replacement involves having the metal ball fixed to the socket and the plastic cup to the upper arm (hence the reversal).
- Symptoms lasting 6-12 months
- Tear larger than 3cm with good surrounding tissue
- Significant weakness and loss of function in the shoulder
- The cause was a recent, acute injury
This type of surgery often involves reattaching the tendon to the head of the humerus, and there are a few surgical options that we will discuss with you.
For shoulder replacement surgery, the damage is to the shoulder bones or joints rather than the tendons. Our surgeons will replace the damaged bone and put in prosthetics to restore shoulder function. There are two types of shoulder replacement surgeries: conventional and reverse. Traditional shoulder replacement involves replacing the shoulder socket with a plastic cup and metal ball on the upper arm bone.
It requires that the rotator cuff is functioning correctly. Suppose a patient is suffering from a massive rotator cuff tear or shoulder arthritis (arthropathy). In that case, our surgeons may recommend the reverse total shoulder replacement because it does not require the rotator cuff for it to be effective. Instead, it relies on the deltoid muscle. The reverse shoulder replacement involves having the metal ball fixed to the socket and the plastic cup to the upper arm (hence the reversal).
Types of Rotator Cuff Tear Repair Options
There are various types of rotator cuff repair techniques that can be used for patients who have sustained injuries or have developed degeneration in the shoulder, especially in the dominant arm's shoulder. These techniques and procedures include open repair, all-arthroscopic repair, double row repair, and acromioplasty repair.
At Atlanta Bone and Joint Specialists, we are committed to helping you get your life back when you feel ready. We use the latest and greatest technology and minimally invasive approaches to ensure the best possible outcomes for your treatments. We let you tell us when you are ready to have your surgery. You will never feel pressured to undergo surgery if you don’t feel prepared. During your consultation with our surgeons, we will advise you of your options and which techniques best suit your circumstances.
At Atlanta Bone and Joint Specialists, we are committed to helping you get your life back when you feel ready. We use the latest and greatest technology and minimally invasive approaches to ensure the best possible outcomes for your treatments. We let you tell us when you are ready to have your surgery. You will never feel pressured to undergo surgery if you don’t feel prepared. During your consultation with our surgeons, we will advise you of your options and which techniques best suit your circumstances.
Open Rotator Cuff Repair
The open surgical incision to repair the rotator cuff was the first technique used to treat this condition. It is a good option if the tear is large or complex or additional reconstruction is needed, such as a tendon transfer. We can also remove bone spurs from beneath the acromion (known as an acromioplasty).
Arthroscopic Rotator Cuff Repair
The least invasive repair method is the all-arthroscopic repair. This technique involves your surgeon inserting a small camera (arthroscope) into your shoulder joint, which sends images of your shoulder to a television screen. The images are then used to guide tiny surgical instruments as they make small incisions in the rotator cuff area. All-arthroscopic repair is typically an outpatient procedure.
Double Row Rotator Cuff Repair
During an all-arthroscopic repair, the surgeon can perform a single-row or double-row repair for the tendon to the bone. A double-row repair uses two rows of suture anchors instead of one. This provides more reconstruction, decreased strain, and increased stiffness across the repair, smaller gap formation and “dog ear” deformities, and a better healing environment.
Acromioplasty Rotator Cuff Repair
There are four muscles of the rotator cuff, and the tendon which connects these muscles to the top of the arm bone may become pinched between the two bones (shoulder impingement). This can be very painful for the patient, especially when lifting the arm to the side and above shoulder height. To relieve the pain from the impingement, surgeons can shave away part of the acromion bone that pinches the rotator cuff tendon during an open repair.
Arthrex Rotator Cuff
At Atlanta Bone and Joint Specialists, we make sure that we stay up-to-date with any medical advances in bones and joints. Arthrex has developed some of the most leading, cutting-edge technologies in orthopedics, so we are happy to use their products and innovative procedures to serve our patients in the Atlanta, Georgia, area better.
Rotator Cuff Repair with Biceps Tenodesis
There may also be a simultaneous condition in the biceps tendon for those who are suffering from rotator cuff issues. It is quite common for surgeons to perform an all-arthroscopic rotator cuff repair and biceps tenotomy or biceps tenodesis to resolve both conditions with one surgery and assist with the healing potential for the arm as a whole.
How Long Is the Surgery for Rotator Cuff Repair
While every patient experience is different because of the individual factors and issues that may affect the surgery, it is common for an all-arthroscopic rotator cuff repair surgery to take approximately 2 to 2 ½ hours. However, this does not take pre-operative preparations or recovery time, which may add another 2-3 hours to the full time in the hospital.
For open repair surgery, patients may opt to spend one night in the hospital as part of the recovery process. Additionally, if there are more aspects to the procedures such as acromioplasty, that will add time. Rehabilitation and physical therapy are also not accounted for in this time estimate. Still, they are nonetheless essential in a patient being able to make a full recovery after rotator cuff surgery.
For open repair surgery, patients may opt to spend one night in the hospital as part of the recovery process. Additionally, if there are more aspects to the procedures such as acromioplasty, that will add time. Rehabilitation and physical therapy are also not accounted for in this time estimate. Still, they are nonetheless essential in a patient being able to make a full recovery after rotator cuff surgery.
Rotator Cuff Repair Recovery Time
Recovery from rotator cuff repair surgery is generally about 3-4 weeks of rest and limited mobility or movement. During that time, a patient will meet with a physical therapist 1-2 times per week to monitor the healing progress.
Patients will usually have their arm in a sling to restrict the movement until the 3-4 weeks have elapsed. After that time, physical therapy and rehabilitation can begin where the sling is removed, and re-establishing a normal range of motion becomes the goal. Both in therapy and at home, the patient must be diligent about maintaining the exercise routine.
Patients will usually have their arm in a sling to restrict the movement until the 3-4 weeks have elapsed. After that time, physical therapy and rehabilitation can begin where the sling is removed, and re-establishing a normal range of motion becomes the goal. Both in therapy and at home, the patient must be diligent about maintaining the exercise routine.
Exercises after Rotator Cuff Repair Surgery
The types of exercises that you will do with your physical therapist and at home will depend on the activities that were in your normal routine before the injury. Once the normal range of motion has been re-established, then your shoulder will need to regain strength.
For about 12-16 weeks, you and your physical therapist will work to fully strengthen your shoulder to be comfortable with the pre-surgery activities you were used to doing. Most patients can reach this point within the 12-16 week timeframe. For contact sports or intensive rotation activities (throwing, swinging, etc.), it may take as long as 4-6 months before your shoulder regains its full capabilities.
For about 12-16 weeks, you and your physical therapist will work to fully strengthen your shoulder to be comfortable with the pre-surgery activities you were used to doing. Most patients can reach this point within the 12-16 week timeframe. For contact sports or intensive rotation activities (throwing, swinging, etc.), it may take as long as 4-6 months before your shoulder regains its full capabilities.
Contact Our Rotator Cuff Repair Experts
At Atlanta Bone and Joint Specialists, our doctors and medical team help you get your life back after an injury or chronic pain. We are dedicated to patient satisfaction and improvement, and our doctors take pride in giving patients the time they need during their time in our care. All of our doctors are board-certified and make sure to stay updated on the cutting edge of technology.
We are patient-driven, so we strive to make sure that you understand everything about your condition and the possible treatment methods available to you. Our doctors are happy to take the time to explain your situation to you and provide you with online resources as well.
If you are suffering from shoulder pain that has been developing consistently over time or discomfort stemming from having sustained an injury, you may have a rotator cuff issue.
Contact us to schedule an appointment at one of our three convenient locations in Decatur, Loganville, or Snellville so that we can give your shoulder a full examination, take x-rays, and develop a strategic treatment plan to serve your medical needs best. Learn more about our rotator cuff tear solutions here.
We are patient-driven, so we strive to make sure that you understand everything about your condition and the possible treatment methods available to you. Our doctors are happy to take the time to explain your situation to you and provide you with online resources as well.
If you are suffering from shoulder pain that has been developing consistently over time or discomfort stemming from having sustained an injury, you may have a rotator cuff issue.
Contact us to schedule an appointment at one of our three convenient locations in Decatur, Loganville, or Snellville so that we can give your shoulder a full examination, take x-rays, and develop a strategic treatment plan to serve your medical needs best. Learn more about our rotator cuff tear solutions here.
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