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Surgery may be used to treat a rotator cuff disorder if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.
The rotator cuff is a group of four tendons and the related muscles that stabilize the shoulder joint and allow you to raise and rotate your arm. The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). These bones are held together by muscles, tendons, ligaments, and the joint capsule. The rotator cuff helps keep the ball of the arm bone seated into the socket of the shoulder blade.
Surgery to repair a torn rotator cuff tendon usually involves:
In open shoulder surgery, a surgeon makes an incision [2 in. (5 cm) to 3 in. (7.6 cm)] in the shoulder to open it and view the shoulder directly while repairing it. A smaller incision can be done with a mini-open procedure that allows the surgeon to reach the affected tendon by splitting the deltoid muscle. This method may reduce your chances of problems from a deltoid injury.
Open-shoulder surgery often requires a short stay in the hospital.
Rotator cuff tears can sometimes be repaired with arthroscopic surgery.
Discomfort after surgery may decrease with taking pain medicines prescribed by your doctor.
The arm will be protected in a sling for a defined period of time, especially when at risk of additional injury.
Physical therapy after surgery is crucial to a successful recovery. A rehabilitation program may include the following:
Surgery to repair a rotator cuff is done when:
Rotator cuff repair surgery for a tear from a sudden injury works best if it is done within a few weeks of the injury.1 But repairs of very large tears are not always successful.
Rotator cuff surgery to repair frayed or thinned tendon tissue is less likely to work than surgery to repair an injury to a healthy tendon.
In addition to the risks of surgery in general, such as blood loss or problems related to anesthesia, complications of rotator cuff surgery may include:
Very large tears [greater than 2 in. (5 cm) or involving more than one rotator cuff tendon] often cannot be repaired. Grafting and patching procedures are possible. But they are not much better at restoring strength than debridement and smoothing, which are less risky and require less rehabilitation.
Less active people (usually those older than 60) with confirmed rotator cuff tears that do not cause pain, significant weakness, or sleep problems can safely go without surgery unless symptoms get worse.
- American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Rotator cuff tears. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 311–316. Rosemont, IL: American Academy of Orthopaedic Surgeons.
Other Works Consulted
- Beasley Vidal LS, et al. (2007). Shoulder injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 118–145. New York: McGraw-Hill.
- Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986–1015. Philadelphia: Saunders Elsevier.
- Murphy RJ, Carr AJ (2010). Shoulder pain, search date August 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Last Revised: November 30, 2011
Author: Healthwise Staff
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