Rotator Cuff Repair
Arthroscopy is a minimally invasive surgery technique that is used to repair a damaged/torn rotator cuff. A few small incisions are made around the joint to allow a camera and various instruments to pass through. These instruments are used to visualize the anatomic structures in the shoulder and to repair the torn rotator cuff tendon. Small holes in the bone are made to release stem cells from the bone to augment the healing.
Why Shoulder Arthroscopy
A shoulder arthroscopy is a minimally invasive procedure used to repair a rotator cuff. It includes creating 3-4 small incisions (roughly 0.5 inch each) around the shoulder joint. These small portals allow a camera to enter the joint for visualization of anatomic structures, as well as tools to repair any injured structures. To repair the rotator cuff, small plastic or absorbable anchors (about 4-5 mm in size) are inserted into the bone where the rotator cuff used to be attached. These anchors contain sutures that are passed through the rotator cuff tendon and then tied. This allows the tendon to be secured back to its anatomic position. The type of repair and the number of anchors used depends on the size of the tear.
- This surgery is most often performed under general anesthesia with a nerve block, but can be performed with a nerve block and sedation.
- This surgery is usually outpatient, which means the patient will be able to go home the same day.
- Surgery typically lasts 1.5-2 hours.
- Patients are fit for a sling at a preop appointment before surgery and will need to bring this to surgery.
- The sling will be placed on the patient prior to waking up from anesthesia.
- The incisions will be closed with absorbable sutures and covered with dressings that can usually be removed 2-3 days after surgery.
6 weeks. The sling should be removed at least 3x/day for elbow, wrist, and finger range of motion exercises as will be instructed.
No. Driving with a sling is considered driving impaired and could be subject to a citation.
Yes. Patients are usually unaware of their arm movements at night. The sling helps to ensure that the arm stays in a good position for healing.
Physical therapy typically starts 2 weeks after surgery. This can change, depending on the size of the rotator cuff tear.
2 days after surgery. Once you remove the bandages, you will see 3 sticky white strips covering the wounds. These are called steri-strips and should be left in place until your first postoperative appointment.
The ice machine should be used for about 30 minutes at least 3 times a day until your first postop. You may ice more frequently if desired.
An anesthetic injection performed by the anesthesiologist to turn off pain signals that go to a targeted region.
This will be discussed at your preop appointment. If a narcotic is prescribed, the risks and side effects will be reviewed with you. We encourage you to try and discontinue these by your first postop appointment. Depending on your health history, you may be encouraged to take anti-inflammatories and Tylenol instead of the narcotics.
Different types of anchors are used depending on the age of the patient, but most of the time anchors made up of a special type of plastic called PEEK are used. Suture anchors that resorb over time are used less frequently.
The overall risk of a complication is less than 1%. The most common risk is shoulder stiffness from scarring. Other more rare risks include infection, bleeding, and persistent pain.