Rotator Cuff Surgery

Rotator Cuff Surgery Meaning

The rotator cuff is a group of four muscles and tendons that hold the shoulder joint in place and allow it to move freely. A rotator cuff tear can occur when one or more of these tendons tears, either partially or completely. Rotator cuff tears are most common in athletes and people over the age of 40. However, they can also occur in younger people who lift heavy objects or perform repetitive overhead activities.

Rotator cuff surgery is a major operation that involves sewing the rotator cuff tendons back to the upper arm bone. Rotator cuff surgery is usually performed arthroscopically. This is a minimally invasive procedure in which the surgeon inserts a small camera and surgical instruments into the shoulder joint through small incisions. The surgeon then uses the camera to guide the instruments to repair the torn tendon.

In some cases, open surgery may be necessary. This is a more invasive procedure in which the surgeon makes a larger incision in the shoulder to access the torn tendon.

Symptoms of a rotator cuff tear include:

• Pain in the shoulder, especially when lifting or rotating the arm

• Weakness in the shoulder

• Reduced range of motion in the shoulder

• A popping or crunching sound when moving the shoulder

There are three main types of rotator cuff surgery:

1. Arthroscopic rotator cuff repair 

• This is the most common type of rotator cuff surgery.

• Arthroscopic rotator cuff repair is the preferred surgical approach for most rotator cuff tears. 

• It is a less invasive procedure than open rotator cuff repair, and it has a shorter recovery time. However, arthroscopic rotator cuff repair may not be appropriate for all tears, such as large or complex tears.

  2. Mini-open rotator cuff repair

• This is a hybrid procedure that combines elements of both arthroscopic and open rotator cuff repair.

• Mini-open rotator cuff repair is a good option for patients who have tears that are too large or complex for arthroscopic repair, but who do not want to undergo the more invasive open rotator cuff repair procedure.

3. Open rotator cuff repair

• This is the least common type of rotator cuff surgery. It is a more invasive procedure that is performed through a larger incision over the shoulder. 

• Open rotator cuff repair is typically reserved for large or complex tears that cannot be repaired arthroscopically or with a mini-open approach.

The type of rotator cuff surgery that is best for you will depend on the size and location of your tear, your age, and overall health, and your surgeon's preference.

The rotator cuff surgery procedure will vary depending on the type of surgery being performed. However, the general steps are as follows:

Arthroscopic rotator cuff repair

1. The patient is placed under general anesthesia.

2. A small incision is made over the shoulder.

3. The arthroscope is inserted into the shoulder joint through the incision.

4. Additional incisions are made to insert other surgical instruments.

5. The surgeon uses the arthroscope to visualize the torn tendon.

6. Special instruments are used to clean and prepare the torn tendon.

7. Sutures are used to attach the tendon to the bone.

8. The surgical instruments are removed, and the incisions are closed with stitches.

Mini-open rotator cuff repair

1. The patient is placed under general anesthesia.

2. One or two small incisions are made over the shoulder.

3. A small camera is inserted through one of the incisions to visualize the rotator cuff.

4. The surgeon uses special instruments to repair the torn tendon through the other incision.

5. The surgical instruments are removed, and the incisions are closed with stitches.

Open rotator cuff repair

1. The patient is placed under general anesthesia.

2. A larger incision is made over the shoulder.

3. The deltoid muscle is detached from the humerus (upper arm bone) to expose the rotator cuff.

4. The surgeon uses special instruments to repair the torn tendon.

5. The deltoid muscle is reattached to the humerus.

6. The incision is closed with stitches or staples.

After surgery, the patient will be placed in a sling to protect the shoulder. The sling will be worn for several weeks to allow the tendon to heal. Physical therapy will be started early in the recovery process to help regain strength and range of motion in the shoulder.

Side Effects of Rotator Cuff Surgery

• Nerve injury: One study found that 1–2% of patients experience nerve damage.

• Infection

• Pain or loss of strength

• Complex regional pain syndrome (CRPS)

• Fracture

• Stiffness

• Recurrence of the tear

Other side effects of rotator cuff surgery may include:

• Anesthesia risks (such as allergic reactions, heart problems, and breathing problems)

• Blood clots

• Stiffness

Benefits of Rotator Cuff Surgery

• Pain reduction

• Improved shoulder function

• Increased shoulder mobility

• Restored shoulder strength

• Faster recovery than traditional open surgery

• High success rate

The recovery time from rotator cuff surgery varies depending on the size and location of the tear, the type of surgery performed, and the patient's age and overall health. However, most patients can expect to wear a sling for several weeks after surgery and to participate in physical therapy for several months.

Here is a general overview of the rotator cuff surgery recovery timeline:

Weeks 1-4:

• Wear a sling to protect the shoulder.

• Perform gentle exercises to maintain range of motion in the shoulder.

• Begin physical therapy to regain strength and range of motion.

Weeks 4-8:

• Continue physical therapy to regain strength and range of motion.

• Start to wean off of the sling.

• Avoid lifting heavy objects or doing strenuous activities.

Weeks 8-12:

• Continue physical therapy to regain strength and range of motion.

• Start to return to light activities, such as walking and swimming.

• Avoid heavy lifting and strenuous activities.

Months 3-6:

• Continue physical therapy to regain strength and range of motion.

• Return to most activities, including sports and recreation.

• Avoid heavy lifting and strenuous activities until cleared by your surgeon.

It is important to note that this is just a general overview of the rotator cuff surgery recovery timeline. Your surgeon may have specific instructions for you depending on your individual situation.

Here are some tips to speed up recovery after rotator cuff surgery: 

• Wear a sling

• Sleep carefully

• Ask for help

• Watch for complications

• Do the physical therapy

• Keep comfortable

• Be mindful of your movement

• Pace yourself

• Follow your surgeon's instructions carefully.

• Eat a healthy diet

• Avoid lifting heavy objects or doing strenuous activities until your surgeon clears you to do so.

The cost of rotator cuff surgery in Delhi varies depending on the type of surgery performed, the hospital or clinic where the surgery is performed, and the surgeon's fees. However, the average cost of rotator cuff surgery in Delhi is between ₹2,30,000 and ₹5,00,000.

Here are some factors that can affect the cost of rotator cuff surgery:

• Type of surgery: Arthroscopic rotator cuff repair is generally less expensive than open rotator cuff repair.

• Hospital or clinic: Hospitals and clinics in major cities tend to be more expensive than those in smaller cities.

• Surgeon's fees: Surgeon's fees vary depending on the surgeon's experience and reputation.