Surgical treatment options for rotor cuff tears

Rotor cuff tear surgeries often involve re-attaching of the tendons to its original position which is the head of humerus. If it is a partial tear, only smoothening or trimming  procedure will be carried out by shoulder surgeons.  When the tearing is complete, it has to be repaired by stitching it to the original position on the humerus.

Circumstances where rotor cuff surgery is unavoidable

If non surgical methods are not able to provide any improvement to the shoulder pain experienced by the patient, his doctor may advice for surgical procedure as his last attempt to solve the problem.  Continued pain is the single reason that necessitates surgical intervention. Other situations that contribute to the surgical procedure are discussed below.

If your symptoms have continued for more than 6-12 months without any change even after attempting conventional treatment options.

• If the tear is more than 3 cms in length and the tissues surrounding the tear are damaged
• If you experience weakness and  function  loss in your shoulder
• The tear was caused by a recent injury which is acute in nature.

Surgical repair options

There are a few common procedures followed for solving rotor cuff issues. Each method has its own advantages and disadvantages. All the surgeries are aimed at healing the tendon and restoring the lost motion. The surgeon’s experience, your anatomy, size of the tear, quality of the bone and tendon tissue etc are some of the factors that affect the selection of the suitable procedure in one case. Some of these procedures can be done as an outpatient procedure.
The surgeon will discuss the matter with  the patient while finalizing the suitable surgical procedure for a particular patient. The other problems like bicep tendon tears, bone spurs, osteoarthritis etc will also be taken care of by your surgeon while carrying out the surgical procedure for eliminating rotor cuff problems.

Open repair

In the conventional open surgery method a long incision will be needed if the tear is large.
The incision will be made over the shoulder and the deltoid muscle will be detached to gain access to the damaged tendon. During this procedure the surgeon removes born spurs through a procedure known as acromioplasty. Over the years an improved procedure known as less invasive procedure has evolved.

Arthroscopic repair

In this procedure the surgeon inserts a device known as arthroscope which contains a small camera and a light into the area where surgery is to be performed through a small incision made near the shoulder. With the help of the light and camera the surgeon examines the affected area and if necessary special tools are inserted through the arthroscope or through other small incisions made near to the original incision and the repairing work is completed. This procedure is usually carried out on out-patient basis. As this is less invasive the pain and blood loss and recovery time will be much lesser than the conventional one.

Mini open repair

This is a new technology in    which newer instruments and technology  are made use of. The incision +-for this procedure will be3-5 cms long. Arthroscopic technology is used to access the problematic area and find out the condition inside the shoulder joint. Born spurs are removed arthroscopically. This eliminates the necessity to detach deltoid muscle. After completing the arthroscopic procedure the surgeon carries out the repairing of the rotor cuff through a new procedure known as mini-open surgery. Instead of viewing through a monitor the surgeon views the structure of the shoulder directly.

Recovery

You will feel pain after the procedure. The doctor will provide medications to reduce the pain. The doctor may make use of some combinations of pain relieving medications like opioids, NSAIDs, local anesthetics etc.

The patient has to understand that opioids can be addictive even though they are helpful in reducing the pain. Overuse of opioids has often become a critical health issue. it is important that opioids have to be purchased and used only as per the suggestions of the best shoulder doctor in Mclean.  One should discontinue taking opioids as soon as the pain starts reducing. Discuss the issue with the doctor if the pain is persisting even after weeks after the surgery.