Definition The rotator cuff is made of four muscles in the shoulder and upper arm. The muscles are attached to bones by tough cords called tendons. These muscles help the shoulder joint to function. They also provide stability to the shoulder joint. A rotator cuff repair is a surgical procedure to fix a tear in a rotator cuff. The tear is usually located in the tendon, but sometimes it also involves one of the muscles.
Who is a candidate for the procedure? Persons who have tears to the rotator cuff tendon that don't respond to treatment are candidates for surgery. Surgery is usually needed if there is a complete tear in the tendon. A complete tear results in a person being unable to raise the arm. Surgery may also be needed for a partial tear of the tendon, if the tear causes continued pain and weakness. In a complete tear, repair is usually done within 3 months of the injury.
There are two typical types of people who suffer from a rotator cuff tear. Younger, athletic people often have an injury that tears the rotator cuff. Middle-aged or elderly people usually have repeated stress of the shoulder muscles over time that eventually causes the tendon to tear.
How is the procedure performed? A rotator cuff repair is usually done under general anaesthesia. This means that the person is put to sleep with medications. The surgery is most often done through a 5 - 10 centimetre incision made in the side of the shoulder. The torn tendon is identified. The torn edge is then reattached to the humerus, or upper arm bone, with stitches. This procedure takes about 1.5 to 2 hours.
The procedure can also be done through an arthroscope. An arthroscope is a pencil-sized tube with a light and camera attached to the end of it. It is inserted into a small cut in the shoulder. An image of the inside of the shoulder is then seen on a television screen. Other tools can be inserted through other small cuts to perform the surgery. Surgery with a "scope" results in smaller scars and usually means faster recovery. It cannot be used in all cases, but it is becoming more and more common. Rotator cuff repair surgery is usually done in a day surgery setting, and the individual can go home after a short recovery time.
What happens right after the procedure? After the surgery, people are taken to the surgery recovery room. They are watched closely for a short time. Blood pressure, pulse and breathing will be checked often. A dressing will be put over the incision. A person's arm may be put in a special sling, with a strap around the waist, to keep the arm and shoulder from moving. An ice pack may be applied to the shoulder. Analgesia will be given as needed.
What happens later at home? After surgery, a person usually needs physiotherapy. This allows a person to recover and regain as much use of the shoulder as possible. A person is usually able to return to work within several days, unless his or her job requires heavy lifting.
What are the potential complications after the procedure? There are possible complications with any surgery. These include bleeding, infection, and reactions to the medications used to control pain.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
