Rotator cuff is a group of tendons and muscles in the shoulder, which form a cuff over the shoulder joint. These muscles help to keep the arm at its joint. It also aids in the movement of the shoulder joint. The tendon can be torn or get pinched due to injury or overuse. This rotator cuff tear leads to pain and disability, and weakens the shoulder. People suffering from rotator cuff tear may find difficulty in doing their routine activities like getting dressed or combing hairs.
Rotator cuff surgery is a type of surgery performed to treat the torn rotator cuff. In this surgery, the tendons are reattached to the head of the humerus. Based on the type of tear, the surgical procedure may vary. A partial tear may only require smoothing or trimming procedure. In a complete tear condition, the tendon may be repaired by stitching the tendon to its original position.
Usually, the surgery is recommended if the pain does not go away by nonsurgical methods or have continued pain. The doctor may recommend surgery in some other situations like:
- The symptoms of rotator cuff tear last for 6 to 12 months
- Tear caused due to a recent, acute injury
- A large tear of more than 3 cm in size with good quality of surrounding tissue
- Significant loss of weakness and function in the shoulder
PREPARATION BEFORE PROCEDURE
During your first visit to the surgeon, medical history and information about your symptoms will be obtained. The doctor will then examine your shoulder to evaluate the condition properly. Your arm will be moved in different directions to determine the range of motion. The strength of the arm will also be examined. Some other imaging tests like X-ray or MRI may also be done.
Based on your condition, the doctor will suggest the best treatment for you. If you experience continued pain, rotator cuff surgery would be the best treatment option.
Surgery can be of the following types:
- Open repair: In this method, a long incision is made over the shoulder. This method is usually used to treat complex or large tear. After making the incision, the deltoid muscle (a triangular, rounded muscle present on the uppermost part of the arm) is detached for a better view of the torn tendon.
- All-arthroscopic repair: In this method, a minimal incision is made over the shoulder. An arthroscope with a small camera is inserted into the shoulder joint. The image captured by the camera is displayed on the attached screen. These images aid in guiding the surgical instruments. This method is the least invasive method among all methods performed to treat torn rotator cuff.
- Mini-open repair: In this method, a small incision (3 to 5 cm long) is made over the shoulder. New instruments and technology are used in this method. To assess and treat the damage to the other structures within the joint, arthroscopy is used. After completing the arthroscopic portion, the rotator cuff will be repaired through the mini-open incision. In this method, the surgeon will directly view the structures, not through the monitor.
Rotator cuff surgery is performed under regional or general anaesthesia. Based on the factors like size of the tear, quality of the tendon tissue and bone, and anatomy of the cuff.
After completing the procedures, the stitches are closed with the help of the sutures or staples.
After the surgery, you may experience some amount of pain. Do not worry, as this is the normal part of the healing process. Medications like opioids, local anaesthesia or non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to relieve the pain. A sling will be given to keep the arm stable. This sling protects the tendon during the healing process.
After 4-6 weeks of the surgery, the shoulder recovers, and it is good for the movement. A physiotherapist will help you to do passive exercises to improve the movement of the shoulder. After 8-12 weeks of the surgery, you will start doing strengthening exercises.
Following measures may help in speedy recovery after rotator cuff surgery:
- Avoid using your arm for first 4-6 weeks
- Consult your doctor if the pain persists for a long duration
- Consult your doctor before starting any sports activity
FACTORS AFFECTING COST
The cost of rotator cuff surgery may vary based on several factors, such as:
- Type of the procedure
- Type of the hospital
- Extend of the tear
- Any other condition associated
- Experience of the surgeon
- Duration of the hospital stay (if required)
- Medications given during the procedure