Rotator Cuff Tear

The shoulder joint consists of three bones built in the shape of a crater and leaves - the scapula, clavicle and arm bones. The joint is strengthened and stabilized by a group of muscles that surround and anchor it to the side of the crater in the joint - the rotator cuff. These muscles wrap around the head of the humerus and connect the humerus to the scapula.

Rupture of the rotator cuff is a common cause of shoulder pain and disability in adults. The rupture causes the shoulder to weaken and makes it difficult to perform many routine operations such as combing the hair or putting on a shirt.

When is it recommended to perform a surgery?

For most patients, improvement in pain and shoulder function can be achieved through non-surgical treatment that includes rest, activity adjustment, pain medication, and tailored physical therapy. In some cases it can also be treated with steroid injections into the joint.

If the pain does not improve with conservative treatment, your doctor may recommend surgical treatment. Another reason for recommending surgery is if you are very active in your routine in  a position of holding your hands above head height. There are additional indications that it is best to seek surgical treatment early, which is recommended to be discussed with your doctor.

The course of the surgery

The surgery is designed to repair the damage to torn muscles and tendons, and is performed under general anesthesia. The repair itself is performed by suturing or anchoring the muscles, sometimes while separating ligaments or making changes in the bony structure (of the bones) of the shoulder, depending on the nature of the injury.

The surgery can be performed with an arthroscopic approach, in which a camera and other minimally invasive equipment are inserted into the joint space through tiny incisions, or with an open approach - using a larger incision. The choice of approach will be made depending on the type of injury and the intervention required. The duration of the surgery also depends on the type of surgery planned.

Preparation for surgery

Before the operation, an examination must be performed by an orthopedic specialist. In addition, the medical validity and preliminary tests done will be examined, in order to plan the surgery in the best way for you. On occasion it is necessary to perform additional tests before surgery.

In addition, a preliminary evaluation by an anesthesiologist should be performed. You should be in  complete food and liquid fast according to staff instructions.

Recovery after the procedure

Some patients may be discharged home as early as the day of surgery. The discharge depends on your general medical condition and the course of the surgery. After the operation, the hand and arm will be placed on a hanger to relieve any load on the shoulder.

In the first few days, it is important to allow the hand to rest as much as possible, take painkillers as needed and leave the hand on the hanger for 2-6 weeks, depending on the personal recovery and the surgeon's recommendation. Performing rehabilitation, including physical therapy exercises to gradually strengthen the shoulder is also important for full recovery.

Possible complications

The proportion of patients suffering from postoperative complications is very low, but it is present as in any surgical intervention.

In addition to anesthesia-related complications, repairing a ruptured rotator cuff may result in a risk of nerve damage, local infection, a rupture of the deltoid muscle, and the development of stiffness in the shoulder. In rare cases, another rupture of the rotating cuff may develop.