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Rotator Cuff Repair Surgery - Diagnosis & Procedure

Get a detailed diagnosis and suitable treatment for rotator cuff repair in India at Pristyn Care. Consult the highly experienced surgeons to undergo Rotator Cuff Repair Surgery.

Get a detailed diagnosis and suitable treatment for rotator cuff repair in India ... Read More

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    Dr. Kamal Bachani (3uCOy0grwa)

    Dr. Kamal Bachani

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    32 Yrs.Exp.

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    32 + Years

    Delhi

    Orthopedics

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    Dr. Sharath Kumar Shetty (HVlM9ywqHb)

    Dr. Sharath Kumar Shetty

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    20 + Years

    Bangalore

    Orthopedics

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    Dr. S.D.I Ranjit (tzGkRH0q3b)

    Dr. S.D.I Ranjit

    MBBS, DNB
    18 Yrs.Exp.

    4.8/5

    18 + Years

    Bangalore

    Orhopedician.

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    Dr. Abhishek Bansal (X1TASpV05r)

    Dr. Abhishek Bansal

    MBBS, MS (Ortho), DNB- Orthopedics, M.R.C.S.
    17 Yrs.Exp.

    4.5/5

    17 + Years

    Delhi

    Orthopedic Surgery.

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  • What is Rotator Cuff Repair?

    Rotator cuff surgery is usually performed in patients with a torn rotator cuff. The rotator cuff is a group of muscles and tendons surrounding the shoulder joint that keeps the upper arm firmly in the shoulder joint socket. The surgery can be performed traditionally (with an open incision) or minimally invasively (arthroscopically).

    Rotator cuff injuries are very common, mostly in older people or people who frequently perform overhead motions, like painters, carpenters, etc. Normally, rotator cuff injuries happen over time and can be treated conservatively if caught in time. However, severe tears or tears that occur due to a single trauma are normally treated surgically.

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    Diagnosing Rotator Cuff Injuries

    Before treatment of rotator cudd injuries doctor usually suggests a few diagnostic tests to understand the severity of the condition. Some of the common diagnostic tests are as follows: 

    • X-rays: This test is usually performed to visualize bone abnormalities such as bone spurs, joint dislocation, and arthritis, helping identify the underlying source of pain.
    • Ultrasound: This imaging technique enables visualization of soft tissues like muscles and tendons, allowing the surgeon to assess for tears, sprains, or other abnormalities.
    • Magnetic Resonance Imaging (MRI): MRI employs radio waves to produce detailed images of the shoulder’s internal structures, aiding in accurate diagnosis and treatment planning.

    Once the diagnosis is confirmed, the surgeon discusses the appropriate treatment options with the patient. Mild to moderate tears are typically managed conservatively through approaches such as medications, steroid injections, and physical therapy. However, in cases of severe rotator cuff tears, surgery is often recommended.

    Are you going through any of these symptoms?

    Rotator Cuff Treatments Options- Surgical and Non-Surgical

    Rotator Cuff Surgery: Surgical Options

    Different surgery options for rotator cuff surgery are as follows:

    • Traditional open surgery: In this surgical procedure, a large incision is made on the shoulder to access the injured tendon. The surgeon then stitches the torn tendon back into the bone using conventional surgical tools. This surgical procedure helps in direct visualization and thorough repair but often entails a longer recovery period and increased postoperative discomfort compared to minimally invasive alternatives.
    • Arthroscopic surgery: In arthroscopic rotator cuff repair surgery, the surgeon uses a small camera and specialized instruments through small incisions to address the injured tendon. This minimally invasive procedure provides a clear view of the shoulder joint on a monitor, enabling precise repairs. Arthroscopic surgery often leads to faster recovery, minimal postoperative pain, and smaller scars when compared to traditional open repair methods. 
    • Mini-open repair: Mini-open repair surgery for rotator cuff entails a smaller incision, typically ranging from 3 to 5 cm in length. The surgeon utilizes arthroscopic guidance to assess the damaged tendon and then makes the necessary repairs through the mini-incision. This approach combines the benefits of both arthroscopic and open techniques, providing improved visualization and more extensive repairs than arthroscopy alone while still resulting in less postoperative pain and a shorter recovery period than traditional open surgery.

    How to prepare for rotator cuff surgery?

    Before the rotator cuff repair surgery, you should follow the given preparatory steps to ensure treatment success and comfort during the treatment journey:

    • Discuss your health condition with your surgery provider. Tell them about all medicines, supplements, or medical herbs you are currently taking. If you are taking any blood thinners or medicines that may cause anesthesia-related complications, you may need to stop them before the surgery.
    • If you have any pre-existing conditions like diabetes, heart disease, hypertension, etc., you may need approval from your regular care provider before getting the surgery.
    • Stop tobacco and alcohol consumption, especially smoking, a few days before the surgery as they can interfere with the patient’s healing ability.
    • If you have a fever, cold, or other infection before the surgery, inform your surgery provider, so they can prepare accordingly.
    • Prepare an overnight bag as you may be hospitalized for 1-2 days after the surgery. Do not eat anything after midnight on the day of the surgery, especially if your surgery is to be performed under general anesthesia.

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    Benefits of Arthroscopic Rotator Cuff Surgery

    Arthroscopic rotator cuff repair is highly effective in alleviating shoulder pain, restoring strength, and improving overall shoulder function. Patients also regain the ability to perform daily activities, overhead tasks, and sports without experiencing discomfort. Moreover, many individuals report improved sleep conditions as the chronic shoulder ache at night diminishes. With proper post-operative care and rehabilitation, this procedure enables patients to return to an active lifestyle, leading to a significantly enhanced quality of life. Some of the common benefits of rotator cuff surgery are as follows:

    • Less invasive: Arthroscopic rotator cuff surgery involves only small incisions. A less invasive procedure ensures less surrounding tissue is impacted, allowing for reduced scarring, less pain, and a quick recovery.
    • New developments in anchors: The development of new anchors, such as bioabsorbable fully-threaded suture anchors, allow the firm reattachment of the torn rotator cuff to the bone. Anchors can allow for better healing and functioning of the shoulder.
    • Advanced surgical techniques: The use of knotless double row repairs increases tendon-to-bone contact and provides a secure fixation and arthroscopic assisted latissimus dorsi transfer for irreparable posterior rotator cuff tears.
    • Fewer complications: Visibility with a tiny camera results in fewer chances of complications. Plus, with a smaller incision, there are fewer chances of infection than with open surgery.

    Procedure of Rotator Cuff Surgery

    Rotator cuff surgery is usually performed to mend a torn or injured rotator cuff in the shoulder using various techniques tailored to the tear’s size and severity. Before the surgery, a doctor suggests a comprehensive evaluation, including physical exams and imaging tests. A doctor also discusses the procedure’s risks and expected outcomes. The patient is then administered general anesthesia, which induces sleep, or regional anesthesia to numb the shoulder area. During the surgery, small incisions are made, and an arthroscope is used to visualize the tear and assess its extent. The damaged tissue is then repaired using sutures or fixation devices. Post-surgery care, rehabilitation, and physical therapy are crucial for a successful recovery.

    Recovery After Rotator Cuff Surgery

    Enhancing your recovery from rotator cuff surgery involves following these essential tips:

    • Utilize your sling or shoulder immobilizer for the recommended duration to provide support to the healing joint and discourage unnecessary arm movement.
    • Opt for an upright sleeping position to reduce pressure on the healing joint. You can use pillows or a recliner to ensure comfort during sleep.
    • Don’t hesitate to seek assistance from family or friends for everyday tasks such as showering and dressing, especially during the initial recovery period.
    • Commit to your physiotherapy sessions and diligently follow the rehabilitation program prescribed by your physiotherapist.
    • Prioritize rest and try to maintain a comfortable position that minimizes pressure on the operated shoulder.
    • In the initial days after surgery, use ice packs for massaging the area to reduce inflammation. Once the post-surgery inflammation has subsided, switch to heat packs for massaging.
    • Be cautious when moving your shoulder, and avoid putting excessive stress on the joint. Focus on wrist and finger movements while limiting shoulder movement.
    • Recognize that complete recovery may take time, so avoid rushing yourself. Patience is key to ensuring proper healing and preventing setbacks.
    • By adhering to these guidelines, you can optimize your recovery and support the healing process after rotator cuff surgery, regardless of whether it was arthroscopic or open surgery.

    Risk & Complications Associated with Rotator Cuff Surgery

    Generally, rotator cuff surgery is safe and effective in treating the condition, but like any surgical procedure, it also carries certain risks and complications. Some common risks and complications associated with rotator cuff surgery are as follows:

    • Permanent loss of joint motion
    • Weakness of the shoulder joint
    • Allergic reaction to medicines/anesthesia
    • Bleeding or infection
    • Blood clot formation
    • Failure to relieve the patient’s symptoms
    • Permanent injury to a nerve, tendon, or blood vessel
    • Re-tear of the tendon

    It is important to note that complications usually occur during rotator cuff repair if the patient has weakened rotator cuff muscles before the surgery or has a very large tear.  In some cases, the surgery may also fail if the patient does not diligently follow post-surgery care tips and physiotherapy.

    Cost of Rotator Cuff Surgery

    The cost of rotator cuff surgeyr in India typically ranges from INR <minCost> to INR <maxCost>. This is the estimated cost of surgery the final cost can vary depending on various factors, including

    • Type and severity of the injury
    • Consultation and surgeon fees
    • Patient’s age, gender, and health condition
    • Diagnostic tests required
    • Choice of hospital/clinic
    • Duration of the hospital stay
    • Anesthesia cost and anesthetist fees
    • Type of hospital room
    • Cost of postoperative care and follow-up treatment required
    • Cost of physiotherapy
    • Rotator cuff repair Insurance coverage, etc.

    Non-Surgical Treatments of Rotator Cuff

    Non-surgical treatment options for rotator cuff are as follows:

    • Rest and activity modification: A doctor usually recommends rest and activity modification to help reduce joint pain and swelling caused by a partial rotator cuff tear. Doctors also suggest correct ways to perform daily activities, such as lifting items or reaching overhead, to reduce the stress placed on your shoulder. The duration of rest depends on the severity of the condition. You can gradually resume your daily activities as the shoulder heals and symptoms subside.
    • Medication: The inflammation of soft tissue surrounding a rotator cuff tear can cause pain and discomfort in the shoulder, especially while using the arm. Medications can significantly help in managing this inflammation. A doctor usually suggests taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen, to reduce inflammation and pain. If severe shoulder pain prevents you from participating in daily activities such as going to work, doctors may suggest pain relievers for one or two weeks. These medications can mask pain and help you to function. Icing the shoulder periodically throughout the day can also help to reduce pain and swelling. Consult your doctor and ask about how often and for how long icing may be beneficial for you.
    • Physical or occupational therapy: Physical and occupational therapies can help you recover from a torn rotator cuff. It helps you build strength and flexibility in the shoulder, arm, and back muscles. It also helps to stabilize the shoulder joint, relieve pain, improve range of motion, and prevent further tearing. A therapist also suggests how to safely perform daily activities, such as lifting your arm to wash your hair and how to modify your workspace to reduce stress on your injured shoulder. The number of weeks of physical or occupational therapy you do is based on the severity of the rotator cuff tear.
    • Corticosteroid Injections: A doctor may recommend injections of corticosteroids, also known as steroids, if the pain becomes much more severe. These injections have strong anti-inflammatory properties and are typically only recommended if the medications fail to provide relief. A doctor limits the use of corticosteroid injections because their excess uses can weaken the tendons in the shoulder.

    Questions to Ask Your Surgeon

    Before undergoing rotator cuff surgery, it is important to ask the following questions to your surgeon to have a better understanding of the procedure and the risks and complications associated with it:

    • Is rotator cuff repair a major surgery?
    • How long does it take to recover from rotator cuff repair surgery?
    • What is the best way to repair the rotator cuff?
    • What are the different types of rotator cuff surgery?
    • Can a rotator cuff heal without surgery?
    • Is rotator cuff surgery safe?
    • What are the best rotator cuff exercises?
    • What is the success rate of rotator cuff repair?
    • What are the rotator cuff surgery complications?
    • What precautions do I need to take?
    • How does rotator cuff tendinitis feel?
    • How much does a rotator cuff surgery cost?
    • What are the risk factors for rotator cuff surgery?
    • What is the recovery period for rotator cuff surgery?
    • Can the rotator cuff come back after surgery?
    • Who needs rotator cuff surgery?
    • How painful is rotator cuff surgery?

    Signs of a Healing Rotator Cuff

    Depending on the severity of the damage and each person’s health condition, the healing period can vary. The signs of healing in a rotator cuff injury typically take weeks or months. You can notice the following signs during the healing rotator cuff:

    • Decreased pain: It is one of the major signs of healing. As the rotator cuff heals, you can feel a gradual reduction in shoulder pain and discomfort. While some initial discomfort may persist, it progressively diminishes.
    • Improved range of motion: Healing typically results in an increased range of motion in the shoulder joint, making it easier to perform tasks that were previously painful or restricted.
    • Reduced stiffness: Healing helps to decrease inflammation and swelling, leading to improved mobility and reduced stiffness in the shoulder.
    • Decreased inflammation and swelling: As the injury heals, the swelling and tenderness around the rotator cuff area should subside, making the shoulder feel less swollen.
    • Muscle strength improvement: Over time, you may experience increased strength in the shoulder muscles as the healing process progresses. It is important to follow a guided rehabilitation program to rebuild strength safely.
    • Improved sleep: As the pain diminishes, you should experience more restful nights if the injury was previously affecting your sleep.
    • Gradual return to normal activities: As the rotator cuff heals, you can gradually resume regular daily activities and exercises. It is advisable to seek guidance from a healthcare professional to prevent re-injury.

    Remember that individual healing experiences may vary, and some rotator cuff injuries might require medical intervention, such as physical therapy, corticosteroid injections, or, in severe cases, surgery. If you suspect a rotator cuff injury or experience persistent pain and limited shoulder mobility, it is vital to consult a healthcare professional for a proper diagnosis and appropriate treatment plan.

    Frequently Asked Questions

    How should I manage the surgical site after hospital release?

    Change your dressing once every 2 days, or as suggested by your physician. Do not disturb the sutures or incisions. Wrap a watertight bandage around the wound to keep the incision dry while showering or taking a bath.

    When will the physical therapy begin after the surgery?

    Physical therapy typically begins within the first 6 weeks following the surgery, depending on the type of surgery, surgeon and patient preference, etc. Shoulder strengthening generally begins about 12 weeks after the surgery.

    When can I return to sports and recreational activities after the surgery?

    You should wait at least 4-6 weeks before playing sports or putting pressure on your shoulder joint. Before resuming sports or any other activity, you must consult your healthcare provider.

    Which activities should be avoided during the recovery period?

    You must avoid performing active range of motion (AROM) and aggressive and painful passive range of motion (PROM) movements of your shoulder. Avoid activities like pushing yourself up from a lying or seated position with the affected arm and movements that provoke muscle guarding or spasms.

    How long does the surgery take?

    The surgery usually takes about 60-90 minutes, depending on the complexity of the injury and the type of surgery. Arthroscopic tendon repair surgery usually takes 2-3 hours, while a simple flexor tendon repair surgery usually takes 45-60 minutes

    What are the different rotator cuff muscles?

    There are 4 rotator cuff muscles:

    • Subscapularis
    • Infraspinatus
    • Teres minor
    • Supraspinatus

    How to prevent rotator cuff tears?

    There are some steps that you can take to reduce the risk of rotator cuff tears, including

    • Practice regular shoulder conditioning
    • Work the upper body into your exercise routine
    • Maintain good posture
    • Stay at a healthy weight
    • Avoid lifting, catching heavy objects, or raising your arms repeatedly
    • Prevent falls and collisions

    What are the different types of rotator cuff tears?

    Types of torn rotator cuffs repair include:

    • Partial: In an incomplete or partial tear, the tendon still somewhat attaches to the arm bone.
    • Complete: In a full-thickness or complete tear, the tendon separates completely from the bone. There’s a hole or rip in the tendon.

    What are the risk factors for rotator cuff repairs?

    The following factors may increase the risk of rotator cuff repair:

    • Family history of shoulder problems or rotator cuff injuries
    • Poor posture
    • Smoking
    • Being age 40 or older

    What are the symptoms of rotator cuff tear?

    The common symptoms of rotator cuff tear are as follows:

    • Difficulty and pain caused by raising your arm
    • Popping or clicking sounds or sensations when moving your arm
    • Shoulder pain that worsens at night or when resting your arm
    • Shoulder weakness and struggling to lift items
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    Content Reviewed By
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    Dr. Kamal Bachani
    32 Years Experience Overall
    Last Updated : May 21, 2024

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    • SN

      Suneeta Nayak

      5/5

      My experience with Pristyn Care for rotator cuff repair surgery was excellent. The doctors were highly skilled and compassionate, making me feel comfortable and confident about the procedure. They thoroughly explained the surgical process and patiently addressed all my concerns. Pristyn Care's team provided exceptional post-operative care, ensuring my comfort and closely monitoring my recovery. They were supportive and available to answer my questions throughout the journey. Thanks to Pristyn Care, my shoulder is now repaired, and I feel more relieved and satisfied. I am grateful for their expertise and caring approach during this transformative surgery.

      City : LUCKNOW
    • DR

      Deepmala Rawal

      5/5

      Pristyn Care's rotator cuff repair treatment was beyond my expectations! I was hesitant about the surgery, but the team's expertise put me at ease. They customized the treatment to my specific needs and guided me throughout the process. The surgery was a success, and the recovery was better than I anticipated. Thanks to Pristyn Care, I can now move my shoulder without pain

      City : CHANDIGARH