Rotator Cuff Surgery
Rotator cuff surgery is a complex and highly technical procedure. As in any operation there are risks involved with rotator cuff surgery and although generally very good, success rates for cuff surgery can vary.
Typically success rates for treating pain are higher than those when weakness is a significant factor. I want to show that you can directly influence the success of your rotator surgery.
Hopefully, in highlighting how complex these procedures can be; I can explain why surgery is often not the first or best option. I have undergone cuff surgery and I know that it is right option for a lot of people.
I am not suggesting that surgery should not be performed, that would be highly irresponsible and is simply not what I am about. What I hope to show is that surgery alone is not the answer – you are!
What do I mean by that? Well let’s assume you have had a day in hospital and had surgery. What is the single most important factor affecting your surgery recovery?
Again, you are! If you do not adhere to a sensible surgery rehab program, then you, just like I did, will undo all of the surgeon’s hard work.
Rotator cuff surgery techniques
It is easy to talk about decompression surgery rotator cuff, detaching the Deltoid muscle, removing bursa, anchoring tendon to bone, suturing etc. etc.
It all sounds quite simple and clean cut doesn’t it? But this is your body being cut, trimmed, shaved, stitched and if you have to have surgery it is well to remember that simple fact.
Surgical intervention is generally considered for a rotator cuff tear that does not respond to nonsurgical treatment. It is only considered if a tear is associated with weakness, loss of function, and limited motion.
Because there is no evidence of better results in early versus delayed repairs, many surgeons consider a trial of nonsurgical management to be appropriate.
Success rates are high with a satisfactory result being attained in 85 – 90% of cases. A satisfactory result is defined as adequate pain relief, restoration or improvement of function, improvement in range of motion, and patient satisfaction with the procedure.
It is also fair to say that with the improvements in surgical techniques, all these things have become less invasive and therefore any risks are being continually minimised.
The three commonly used surgical techniques for rotator cuff repair are:
- • Open repair
- • Mini-open repair
- • All-arthroscopic repair
Research has shown there are two key points for you to consider in relation to your procedure. Individual surgeon's ability to repair a torn rotator cuff and achieve a satisfactory result varies by technique. Variation is based on both experience and familiarity with the technique.
Results are pretty much equal for open, mini-open, and arthroscopic repair techniques when considering:
- a. Patient satisfaction
- b. Pain relief
- c. Strength
What has been demonstrated quite clearly however is that a surgeon’s expertise is the key factor. This is so much more important in achieving a satisfactory result than the choice of technique employed.
That said, each surgeon will undoubtedly have a preferred technique, so an experienced surgeon using their preferred method would be the ideal.
Rotator cuff surgery complications
There are very few cases recorded nowadays of people having surgery that leads to life threatening situations developing. There are risks however.
Studies have confirmed the following complications or risks associated with surgery. The incidence (shown as a percentage) of each of the risks is an indication only although the figures are thought to be accurate.
- 1. 6% Tendon re tear – The does not necessarily result in the return of pain or loss of function.
- 2. 1% Shoulder stiffness – Early rehabilitation intervention greatly reduces the risks.
- 3. 2% Nerve damage
- 4. 1% Deltoid muscle detachment
- 5. 1% Infection
Other factors that have a direct bearing on a successful outcome for surgery are
- 1. Poor tendon and tissue quality
- 2. Large or massive tears
- 3. Poor compliance with rotator cuff surgery rehab
- 4. Patient age i.e. over 65
It is always best to avoid cuff surgery if at all possible. If surgery is suggested often it is delayed to allow a non surgical approach to be adopted. If this is the case for you then please do the rehabilitation, it really does work.
Similarly if it has to be surgery then please remember that your rotator cuff surgery recovery can be directly influenced by you. If you have a rotator cuff repair then do the surgery rehab. As I have shown rotator cuff surgery is a complicated but successful procedure. Problems are rare and success rates high.
There is one message that is consistently delivered by surgeons from all around the world. Ultimate success is often not achieved purely through a patient’s poor compliance with rotator cuff surgery rehab.