- Rotator cuff repair surgery is performed to repair or fix torn/injured tendons of the shoulder. The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons helps the shoulder to rotate by holding the arm in its “ball and socket” joint. The damage or injury to rotator cuff reduces the strength and limits mobility of shoulder joint significantly.
- Rotator cuff repair surgery can be done in either of three ways, open, mini-open or arthroscopic.
Details of Procedures:
The circumstances that demands the surgery includes:
- A damage or tear to rotator cuff as a result of an acute injury, accident, dislocation, or fracture.
- Medication and physical therapy fails to heal injury and relieve the symptoms, after 3-6 months treatment
- Maximum strength and full shoulder mobility (function) is required for overhead work or sports in healthy young patients
- Repeatedly dislocate or an unstable joint
Symptoms of a rotator cuff include:
- Atrophy or thinning of the shoulder muscles
- Pain and weakness while lifting or rotating the arm
- Crepitus or crackling sensation during certain movements of arm
Facts and Figures:
- The description regarding the rupture of rotator cuff tendon for the first time had been given by Smith in 1834.
- High incidence of rotator cuff tendonitis has been found in workers doing heavy manual labor
- Shoulder pain is the third most common cause of musculoskeletal disorders after low back pain and cervical pain.
- Rotator cuff injury is found in generally seen in a person above the age of 40, mostly in between the age of 55 to 85 years of age.
- Smoking and multiple steroid injections increases the chances of rotator cuff injuries
- Data supports that heredity plays a role in the development of rotator cuff tearing.
Advantages and Disadvantages:
- Rotator cuff surgery had been proved as most effective method to restore comfort and function of shoulders, in a healthy and motivated patient.
- Short hospital stay- depending on the method used patient need to be hospitalized for maximum 1 to 3 days after rotator cuff repair.
- Patients seeking rotator cuff repair through medical tourism can return home within 1 to 3 days in most cases.
- Some rotator cuff tears, where the tendon has been torn for a long time cannot be repaired
- Slow recovery with continued stiffness or recurrent pain of the shoulder.
- Improper healing can create a need to repeat the repair
Pre-operative and Post-operative care:
- X-rays, MRI, or an arthrogram of the damaged shoulder to confirm the extent of the injury
- Complete physical examination
- Blood and urinalysis
- ECG and x-ray chest for patient above 50 years of age
- Consultation with surgeon or doctor a week ago, and have a list of medicine which are to be taken or needed to be stopped.
- Inform the surgeon about habit of smoking and alcohol.
- Arrangement for leave from work, help at home, help with driving, and help for post operative rehabilitation
- Do not eat or drink anything after midnight the night before surgery
- Have enough easy to wear clothes
- Medical tourist are advised to select a comfortable and handicap accessible hotel room, for recovery after getting discharge from hospital
- After the surgery patients need to immobilize the shoulder joint by wearing sling for 3 to 6 weeks.
- The incision area needs to be kept dry and clean.
- It is important to perform the exercises under the supervision of physical therapist to gain good outcome from the surgery.
The physical therapy may include:
- Extension and flexor movement of the wrist ,elbow and hand
- Stretching exercises of arm and shoulder
- Strengthening exercises involving shoulder joint
Gradually routine activities are allowed during rehabilitation phase as the joint strengthens with exercises. The normal activity is usually resumed within 6 to 12 months of the surgery.
It is advisable to do rotator cuff repair relatively soon after the injury or tear to obtained best outcome of the surgery.