Rotator cuff repair

Rotator cuff repair surgery is a procedure that helps restore the function and flexibility of the shoulder and relieve the pain that cannot be controlled by nonsurgical treatments. Rotator cuff repair surgery may consist of shaving off bone spurs that are pinching the shoulder or repairing torn rotator cuff tendons and/or torn muscles in the shoulder.

Reasons for surgery

Approximately 50 percent of people with rotator cuff injuries have pain relief and improved function as a result of nonsurgical treatments. Unfortunately, shoulder strength seldom improves without surgery. If your pain continues after you have used nonsurgical treatments for several months, you are a candidate for rotator cuff repair surgery. Other reasons surgery may be your best options are:

  • You use your arms for overhead work or sports.
  • Chronic shoulder and arm pain have lasted for more than six months.
  • You want to restore your arm and shoulder to its full strength (not always attainable with nonsurgical treatments).
  • You have a large tear in your tendon or muscle (more than three centimeters).
  • Your tear was caused by a recent, acute injury.

Types of surgery

Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of the humerus (upper arm bone). There are a few options for repairing rotator cuff tears. Your orthopaedic surgeon will discuss with you the best procedure to meet your needs. During your surgery, your surgeon may also be able to repair any other shoulder problems such as osteoarthritis, bone spurs or other soft tissue tears.

Advancements in surgical techniques have led to less invasive procedures, such as arthroscopic surgery. Many types of rotator cuff repair can be performed on an outpatient basis. The three main types of rotator cuff repair surgery are:

  • Open repair surgery – The first surgical technique to repair torn muscles and tendons, open rotator cuff repair surgery involves a surgical incision a few inches long. Your orthopaedic surgeon then detaches the shoulder (deltoid) muscle to access the torn tendon. During open repair surgery, your surgeon may also remove bone spurs from the underside of the acromion, the outer end of the shoulder blade (scapula) to which the collarbone is attached. This surgical method often is required if the tear is large or complex and involves additional reconstruction such as a tendon transfer.
  • Shoulder arthroscopy repair surgery – Your surgeon inserts a thin camera (arthroscope) into a very small incision in your shoulder joint to see inside the joint. The camera transmits pictures to a monitor screen which guides the surgeon's miniature surgical instruments in performing the surgery.
  • Mini-open repair –Mini-open repair surgery (a combination of arthroscopy and open surgery) removes bone spurs arthroscopically without having to detach the deltoid muscle. Your surgeon then repairs the rotator cuff directly through a mini-open incision.

The multidisciplinary team of shoulder experts at Northwell Health Orthopaedic Institute performs rotator cuff repair surgery as well as a broad range of nonsurgical and surgical treatments for shoulder and elbow conditions that can occur at any stage of life.

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