Rotator cuff repair

Rotator Cuff Repair


Rotator cuff repair surgery is performed to repair or fix torn or injured tendons of the shoulder. The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. They hold the arm in its ball-and-socket joint, aiding in shoulder movements.

The damage to the rotator cuff reduces the strength and limits the mobilityof theshoulder joint significantly.Rotator cuff repair surgery can be done in either of three ways: open, mini-open or arthroscopic.

Circumstances calling for surgery:

  • Damage, tearing, or instability ofthe rotator cuff due to injury, accident, dislocation, or fracture.
  • Medication and physiotherapy fails to heal injury and relieve the symptoms, even after 3-6 months of treatment   
  • When full shoulder mobility is required for overhead work or sports in young patients.

Symptoms of rotator cuff tear:

  •  Atrophy, pain, and weakness of the shoulder muscles during movement.
  • Crepitus or crackling sensation during certain movements of the arm.

Facts & Figures:

  • Introduced by Smith in 1834,the incidence of rotator cuff tendonitis has been found majorly in workers carrying out 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 generally seen in people above40,mostly between ages 55-85.
  • Family history, and smoking and multiple steroid injections increase the chances of rotator cuff tearing and injuries respectively.

Advantages:

  • Rotator cuff surgery is proven to be themost effective method to restore comfort and function of shoulders in a healthy patient.
  • Depending on the method used, the patient needs to be hospitalized for 1-3 days post-surgery, and medical tourists can return home after a maximum of 3 days.

Disadvantages:

  • If the tendon has been torn for a long time, the rotator cuff cannot be repaired
  • Slow recovery with continued stiffness or recurrent pain.
  • Improper healing can call for corrective surgery.

Pre-operative preparation:

  • X-rays, MRI, or arthrogram of the damaged shoulder to confirm the extent of the injury
  • Complete physical examination
  • Blood and urinalysis
  • ECG and chest X-ray for patient above 50 years
  • Consultation with the surgeon a week prior, and obtainingclear medical prescriptions
  • Inform the surgeon about any habit of smoking and alcohol.
  • Plan for leave from work and domestic help for goodpost-operative rehabilitation
  • Do not consume anything after midnight before surgery
  • Medical tourists are advised to wear comfortable clothes andchoose handicap-accessible hotel roomsfor recovery after getting discharged from the hospital.

Post-operative care:

  • Wear a sling for 3 to 6 weeks to keep the shoulder at rest.
  • The incision area needs to be kept immobilized, dry, and clean.
  • For best results, perform exercises correctly under your physiotherapist’s supervision

Exercises:

  • Extension and flexor movement of the wrist, elbow, and hand
  • Stretching and Strengthening exercises of arms and shoulder joints

One can gradually resume routine activities during rehabilitation phase as the joints strengthen with exercises. It heals completely within 6 to 12 months of the surgery.

It is advisable to do rotator cuff repair relatively soon after the injury or tear to obtain the best outcome of the surgery.