Rotator Cuff Therapy Exercises

Rotator Cuff Tear Surgery

Rotator cuff tear surgery is often the last resort in dealing with a torn rotator cuff.

Unless a major tear is suspected, you are young or involved with professional sports then rehabilitation exercises are often the first treatment option. But if you do require surgery then just exactly what can you expect?

What is done during rotator cuff tear surgery?

During surgery, the patient is generally positioned in a laid back half-sitting position. Something like you would be on a sun lounger and with the head supported at all times.

This provides the surgeon with the best access to the shoulder joint. Most operations are performed under general anesthesia. However, it is becoming more common for a local anesthetic to be used. A local anaesthetic will block the nerves leading to the shoulder and arm.

If you are given a local anaesthetic you will be conscious throughout the operation but will feel no pain. Quite often you will also be given a sedative to thoroughly relax you through the procedure.

I know some of you will not be at all comfortable with being “awake” during the rotator cuff repair procedure. This really is nothing to worry about you are not really aware of what is happening.

There are real benefits to you and the surgery team who can monitor your progress much more efficiently. This decreases the possibility of anything going wrong.

Rotator cuff tear surgery takes up to two hours to perform. You will then spend some time in the recovery area as you are brought round from the anaesthetic.

This is often followed by a period of recuperation on a ward. More and more however rotator cuff tear surgery does not require an overnight hospital stay.

Rotator Cuff Tear SurgeryWhat is done during rotator cuff tear surgery?

There are a number of different procedures that may be required during the rotator cuff repair.

It really depends upon how bad the tear is what caused it and if there are any complicating factors.

The main procedures include

  • -Debridement – removal of damaged tendon tissue
  • -rotator cuff repair -  tendon reattached to the arm bone
  • -rotator cuff impingement surgery – bone removed from the acronium to provide more space for the rotator cuff
  • -Bursectomy – removal of any damaged or inflamed bursa

A partially torn rotator cuff tendon will be tidied up with any frayed, damaged or scarred tendon being removed. Rotator cuff impingement surgery is likely to be carried out to increase the available space and allow good blood flow to the area to aid healing.

If the torn rotator cuff tendon is fully torn and has been torn away from the bone then a full rotator cuff repair will be necessary. In this case the surgeon undertakes the following

  • -The  tendon is cleaned up with any scar tissue removed
  • -A small trough is carved into the upper arm bone
  • -Suture anchors are screwed into the trough in the bone
  • -The tendon is sewn to back to the bone using the anchors

Again impingement surgery and a bursectomy are also likely to be performed.

The actual method the surgeon uses to gain access to the torn rotator cuff varies. Some surgeons still prefer an open surgery which requires a 3 - 4 inch incision in the shoulder.

This is followed by the removal of the deltoid muscle. Some surgeons prefer this approach as it allows them to see the whole joint.

Arthroscopic rotator cuff tear surgery is now routinely conducted. It utilises small instruments inserted through small portals. The surgeon uses a video camera and video screen to guide their actions. There are a number of benefits to you the patient

  • -Less invasive
  • -No need to remove the deltoid muscle
  • -Less scarring
  • -Quicker recovery

Cuff surgery is a fairly routine procedure. With any surgery however there are associated risks but these are not common. The greatest risk to the surgery failing is you the patient.

Tendons take a long time to heal; especially torn rotator cuff tendons as they receive such a poor blood supply. The most common reason given for a poor outcome however is the patient’s failure to undertake rehab exercises.

Following any rotator cuff surgery; rehab exercise is vital. An individual exercise protocol, such as those detailed on this site, will aid in the following ways

  • -Increase range of movement
  • -Prevent scarring
  • -Improve blood supply
  • -Encourage new tendon to be laid down effectively
  • -Strengthen the muscles

 

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