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Shoulder Tendon Repair-Rotator Cuff: Symptoms, Classification, Diagnosis & Recovery

The group of muscles and tendons form a cuff over the shoulder joint which is called as a rotator cuff. The rotator cuff holds the arm in the joint that aids in the movement. When one or more tendon muscle becomes damaged, stiffness, rotator cuff pain and soreness is developed along with decrease in the mobility. Rotator cuff repair is procedure that is used to repair the torn tendon and muscles in the shoulder which can be torn due to injury or overuse. The main goal of the rotator cuff repair is to restore the flexibility and movement of the joint and to decrease the pain.

Reasons for rotator cuff repair

Injuries – Athletics and construction workers are mostly involved in the rotator cuff injury. Repetitive movement and overuse may cause tendon tear.

  • Tear of rotator cuff
  • Inflammation of the tendon
  • Inflammation of the bursa

Advantages

  • Causes less rotator cuff pain
  • Requires less hospital stay
  • Causes less complications
  • Facilitates fast recovery

Treatment options

Partial rotator cuff injury tears can be treated non-surgically by taking rest, non-steroidal anti-inflammatory drugs, steroidal injections, and exercises. Severe rotator cuff injury tears require surgical treatment. The surgical techniques that are used to treat severe tears of rotator cuff include:

  • Arthroscopy
  • Open repair surgery
  • Mini open repair surgery

Arthroscopic surgery

Arthroscopy involves a small incision through which a narrow tube with a fiber-optic video camera is inserted that is connected to a television monitor. The arthroscope is inserted allowing the surgeon to visualize the internal structure of the joint. Small additional incisions are made to insert the surgical tools those are used to repair the joint.

Open repair surgery

This surgery is done for complex tears. During open repair surgery, a large muscle called deltoid muscle is slowly moved away to perform the surgery.

Mini – open repair surgery

The mini-open repair surgery is done by using an arthroscope. The damaged tissue or bone spurs are removed through arthroscopy. Mini-open repair surgery is a combination of both arthroscopy and open repair surgery.

Failure of the non-surgical treatment may cause the need for surgery.

 

  • Your doctor explains you about the procedure and you should clarify with your doctor if you have any doubts.
  • A complete medical examination along with the physical assessment will be conducted by your doctor.
  • You should discuss with your doctor regarding past medical and medication history and allergic reactions towards drugs.
  • Your doctor instructs you to not to take food or drinks at least for 8 hours before surgery.
  • You will be given a sedative to help you relax.

During the surgical procedure

Rotator cuff surgery can be performed on an outpatient basis depending upon the surgical procedure.

Arthroscopic procedure

Arthroscopic surgery involves the use of an arthroscope, which is a narrow tube with a fiber-optic video camera. An anesthetic will be administered which may be a regional anesthetic or a local anesthetic that causes numbness in the shoulder.

Anti-septic solution will be used to clean the surgical site. Depending on the type of surgery, your doctor makes an incision on the surgical site. The arthroscope will be inserted into the surgical site. Then other surgical tools will be inserted through the other incision.

The damaged tendon is then repaired by grafting the tendon from another part of the body. If bone spurs are present, then they are removed. The incision will be closed and a sterile bandage will be applied.

Open repair procedure

Open repair surgeries are performed for complex tears. Torn rotator cuff is a condition that may require this procedure. After administering anesthesia, an incision is made to open the shoulder joint, and the deltoid muscle is then slowly removed or detached to perform the required surgical procedure.

Mini-open repair procedure

This procedure involves 3-5 cm incision and involves advanced technology surgical tools to perform the surgery. The arthroscope is used to perform the surgery.  After the completion of the arthroscopic surgery, the surgeon makes a mini incision to repair and view the joint directly.

Post-surgical care

  • You will be given a sling or a shoulder immobilizer during the discharge from the hospital.
  • You should maintain the wound clean and dry to prevent infections
  • You can use an ice bag on the shoulder if you experience any pain or swelling on the shoulder.
  • You should inform your physician if you experience numbness, fever, severe pain, redness, and drainage from the incision site.
  • Healthy and normal diet can be followed unless your physician recommends a specific diet.

Risks associated with the surgery

  • The stiffness of the joint may remain even after surgery
  • More prone to infections
  • Need for an additional surgery due to damage to deltoid muscle

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