What is the Rotator Cuff?
The rotator cuff is a group of four muscles that work together to help move the shoulder and keep it stable. The muscles are deep to the larger deltoid and pectoralis muscles and are not usually visible under the skin.
What are the major risks of the procedure?
The most common risks are stiffness or repair failure.
Stiffness is relatively uncommon in arthroscopic surgery but it can happen depending on your circumstances.
Repair failure can occur for many reasons and can be related to large size tear, tissue quality, whether you smoke or a host of other factors. It’s best to discuss your individuals risks with your surgeon.
Will you do the procedure through small incisions (arthroscopy)?
Often rotator cuff repair can be performed completely through a series of small incisions that are about a centimeter in length. I perform the majority of my rotator cuff repairs this way.
What are the advantages of arthroscopy?
There are a few main advantages of arthroscopy:
Less pain. Rotator cuff repair via arthroscopy may be less painful. Pain is very subjective however, so it is not always easy to make this comparison.
Open approaches to the shoulder typically involve some detachment or split in the deltoid muscle from the origin. When you use arthroscopy you do not have to detach this muscle and there is minimal risk of the deltoid detaching after surgery. This is a big advantage.
Cosmetics. While even “open” scars can be cosmetic in appearance, arthroscopy incisions tend to be fairly discrete. In my practice I do most rotator cuff repairs completely with arthroscopy. In rare cases I do “open” rotator cuff repairs with a slightly larger incision. This is usually related to the size and retraction of a tear. Some tears are so large and require very sophisticated scar release that patients may be better served with an open repair.
How long is the recovery period for a full thickness rotator cuff repair?
In general the recovery after full thickness rotator cuff repair. breaks down into a few general phases.
Phase 1 is the early postoperative period and usually lasts about 6 weeks. You will wear a sling for the majority of this phase and will see the surgeon about 2 weeks after surgery and at about 6 weeks. Your therapy will focus on active elbow, wrist and hand motion and rarely passive shoulder motion depending on approach.
Phase 2 encompasses week 7-12 and you can usually discontinue wearing your sling. Your therapy should focus on achieving full active motion of the shoulder with excellent mechanics.
After 3 months you will commence strengthening and continue this phase until you reach full strength. You will gradually transition to doing exercises independently.
Maximal improvement after full thickness rotator cuff tear repair often takes up to a year. However, most of your recovery will be achieved in the first 4-6 months and you can usually go back to most heavy activities by then.