Shoulder Tendon Repair - Rotator Cuff

About the Procedure

Rotator cuff surgery is an orthopedic procedure designed for repairing one or more of the four tendons that support the shoulder joint. The most commonly torn of these is the supraspinatus. This is a particularly common injury among professional athletes. The surgery can be executed using one of three methods: open, mini-open and arthroscopic.

The open and mini-open variations involve sizable incisions being made on the shoulder in order to grant direct access to the surgical site. The results of such forms of surgery are reliable and proven, however they do have drawbacks. The recovery time for this type of surgery is quite long due to both the size of the incision and the necessity to cut through a section of the deltoid muscle. Because of this, patients deal with high levels of pain and discomfort during the recovery period as well as more strenuous physical therapy to rehabilitate the newly repaired joint.

The third, and increasingly most common, type is arthroscopic surgery. The procedure is so named due to the use of an arthroscope, a fiber optic camera fitted to the end of a long, narrow, flexible tube. After the patient has been put under general or local anesthesia the arthroscope is inserted into the joint via a small incision (typically less than 1/8 of an inch) and the camera sends what it sees to a video screen for the surgeon to observe. Small, precise instruments are inserted through the incision and the surgery is performed.

First, any loose bits of ligament, cartilage or bone are carefully removed from the surgical site. Then the torn ligament is sewn back together so that it can heal over time. If necessary, the ligament is reconnected to the top of the humerus. Finally, the small surgical incision is sutured shut and the procedure is completed.

The minimally invasive nature of this procedure means the recovery times are very short. This has made arthroscopic shoulder surgery very popular amongst athletes for whom this injury is quite common.

What to Know Before the Procedure

Arthroscopic surgery is safe for most patients. While general anesthesia may be used, local anesthesia is usually sufficient. The incisions are very small and heal quickly, making it easy to recover from, even if the patient is not in good general health. Despite this fact, you should still discuss any allergies you have or any prescribed medications you are on just to ensure there are no complications.

As with most other forms of surgery you should not eat or drink anything starting 12-16 hours prior to the procedure.

What to Know After the Procedure

After the operation, most patients need only an hour or two of recovery time before being able to return home, though they should not attempt to drive themselves. It's a good idea to have someone drive you home and assist you for the first day after the surgery as most patients are drowsy due to the anesthetics.

The surgical area will be swollen for up to two weeks after the operation. This is normal and is no cause for alarm. Once the swelling has subsided, it is safe to resume exercise as prescribed by your doctor. Your doctor may also advise you to undergo physical therapy sessions to return your shoulder to full strength if necessary.

Though the incisions made during arthroscopic surgery are small, caring for them properly is still important. Avoid consuming depressants such as nicotine and alcohol as these can interfere with the healing process. Keep the wounds from the incisions clean, dry and bandaged at all times. If possible, cover the wounded area with plastic while bathing.

If you Need to Travel Outside of your Local Hospital

While there may not be many risks involved with arthroscopic shoulder surgery, it is delicate in nature due to the small operating area and specialized tools required to perform it. Finding a highly qualified surgeon will make a large difference in the recovery time and overall success of the procedure.

Many highly qualified arthroscopic surgeons reside in the United States. There are also qualified surgeons in other countries and, depending on where you travel to, the cost reduction can be very significant. If fast recovery time and strong results are paramount to your lifestyle and cost is of a lower concern, having the surgery done domestically may be your best option. However, if money is a concern, there are many equally qualified surgeons around the world who you may seek out; often for lower price.