Arthroscopic Rotator Cuff Repair

April 16, 2009, Chye Tuan Chng, Senior Physiotherapist

A rotator cuff tear is a common injury of the shoulder. It can be due to a traumatic event where the tendon gets torn in a fall or due to overuse where repetitive overhead activities causes wear and tear of the tendon. Pain is the most significant symptom with a rotator cuff tear followed by loss of range of movement in the shoulder. Arthroscopic rotator cuff repair, which involves minimally invasive surgical techniques, helps to heal the tendon back to the bone. Such surgeries are usually done as a day operation. Rehabilitation of the shoulder post operation takes about 6 months before patients return to functional activities.

Treatment

Treatment for rotator cuff tears ranges from conservative rehabilitation to surgical interventions to repair the torn tendon. Conservative treatment involving rehabilitative exercises is usually the primary course of action. Surgical repair is indicated for a rotator cuff tear that does not respond to conservative management or the tear was found to be large causing severe weakness, loss of movement and function. The decision for conservative management or surgical repair also depends on the patient’s severity of symptoms, functional requirements, and presence of other illnesses that may complicate treatment.

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Arthroscopic rotator cuff repair

Arthroscopic rotator cuff repair involves small incisions on the outside of the shoulder where small surgical instruments are passed through to allow the surgeon to suture or stitch the torn tendon back to the arm bone and allow it to heal. Sometimes the surgeon may remove any scar tissues or bone spurs that may disrupt the healing process.

The advantage of arthroscopic surgery is that a smaller incision causes less pain in the shoulder joint following surgery because it does not require splitting up muscle layers in the shoulder as with the traditional approach. Smaller incisions also mean less superficial scars which is aesthetically more appealing. However, recovery time for the arthroscopic repair is the same as the traditional surgical approach.

After the surgery, you will be placed on a sling to protect the repaired tendons. Rehabilitation with a physiotherapist will start early to reduce the post-operative pain and stiffness. The rehabilitation will progress towards increasing shoulder range and strength after 6 weeks when the tendon heals into the bone. It takes motivation and commitment from the patient to take part in the rehabilitation progress as the whole process takes about 6 months before return to sports or function.

Although most arthroscopic rotator cuff repairs are done as a day surgery, it may sometimes be necessary to stay overnight in the hospital if the doctor needs to monitor the recovery, especially if there is an underlying medical condition.

This work by Musculoskeletal Consumer Review is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Singapore License. This article was contributed by Back2Sports - Sports Injury Management. In the spirit of promoting health education, you may copy, distribute and transmit the work under the conditions specified by the license. For articles re-printed with permission, copyright remains with the original copyright holder (author or publisher). MCR's Creative Commons License does not apply in such cases.