Rotator Cuff Repair

By: Dr. Nick Sacksteder

What Causes Rotator Cuff Problems

The rotator cuff is a group of tendons and muscles in the shoulder that help to lift and rotate your arm. The rotator cuff also helps to keep your shoulder joint in place. However, sometimes the rotator cuff tendons tear or get pinched by the bones around them.  

An injury, like falling on your arm, can cause this to happen, but general wear and tear over time can take its toll on your on the integrity of your rotator cuff too. Shoulder injury symptoms can vary depending on the extent of the rotator cuff tear.  The pain can range from mild to severe.  Patients may experience the inability to lift their shoulder above their head and pain while sleeping. 

Watch this VIDEO to learn more about Shoulder Anatomy

Rotator Cuff Repair Rehab at JOIRotator Cuff Repair

Conservative Treatment of RC Tear

Home care can treat many rotator cuff problems. Your doctor may tell you to rest your shoulder joint and ice the area periodically throughout the day. Over-the-counter pain relievers like aspirin, ibuprofen, and naproxen can also help to ease your pain and swelling while your rotator cuff heals. 

Physical therapy will help restore your shoulder strength and mobility.  Your therapist will have you do specific rotator cuff exercises depending on the size of your tear in the rotator cuff muscle.  Sometimes your doctor may recommend a steroid injection in your shoulder to decrease pain and inflammation.

What if Conservative Treatment Does not Work?

Many rotator cuff problems can be treated at home but if yours is severe and lingers for more than a few months or you are not getting any relief of your symptoms with conservative treatment then rotator cuff repair surgery may be the next option for you. There are several different repairs which can be done for a tear in the rotator cuff. 

Rotator Cuff Repair Surgery May Be Indicated if:

  • Your shoulder has not improved after 6 to 12 months.
  • You’ve lost a lot of strength in your shoulder and find it painful to move.
  • You have a large tear (over 1 inch) in your rotator cuff tendon.
  • You are active and rely on your shoulder strength for your job or to play sports.

The Most Common Types of Rotator Cuff Repair

  • Arthroscopic rotator cuff repair - After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder. These will let him see which parts of your rotator cuff are damaged and how best to fix them.
  • Open tendon rotator cuff repair - This surgery has been around a long time. It was the first technique used to repair the rotator cuff. If you have a tear that’s very large or complex, your surgeon may choose this method.

What is the Regeneten Patch?

Regeneten is a collagen based bioinductive implant. The patch is small in size (postage stamp) and is placed on top of the rotator cuff. The patch facilitates the formation of new tissue growth, increase tendon thickness, and restores a more natural attachment point to the body. Cell ingrowth and collagen formation into the patch is within 5 weeks and by 6 months the patch will no longer be visible as the implant is absorbed and becomes tendon-like tissue. An increase in thickness of rotator cuff of about 2-3mm following surgery is seen with use of the Regeneten Patch.

  • Advantages of Regeneten Patch
  • Tendon Healing
  • Shorter Rehabilitation
  • Quicker Recovery
  • Pain Relief
  • Less surgical tissue trauma
  • Decrease duration in post-surgical sling

What Type of Rotator Cuff Repair Surgery Do I Need?

Rotator cuff repair surgery can relieve your pain and restore function to your shoulder. Most rotator cuff repair surgeries can be done on an outpatient basis while for other more severe cases, you may need to stay in a hospital.  

Both of these surgeries can be done under general anesthesia, which allows you to sleep through the whole thing. They can also be done with a “regional block,” which allows you to stay awake while your arm and shoulder stay numb.  

You can talk to your doctor ahead of time about the type of anesthesia you prefer.

Recovery from Rotator Cuff Repair Surgery

Recovery from arthroscopic rotator cuff repair surgery is typically quicker than the open tendon rotator cuff repair surgery. Since the open tendon rotator cuff repair surgery is more involved, you may also experience more pain immediately afterward.  

No matter which surgery you have, a full recovery will take time and you should expect to be in a sling for about 6 weeks. Wearing the sling protects your shoulder and gives your rotator cuff time to heal. Often times, driving a car will be off-limits for at least a month.  

Most people don’t get instant pain relief from surgery and it may take a few months before your shoulder starts feeling better. 

Until then, your doctor will advise you to take over-the-counter pain relievers.  Opioid painkillers are also an option but come with the risk of addiction. If your doctor prescribes them, it’s crucial to take them only as directed. Stop using them as soon as your pain goes away or when your pain can be controlled by other medications like acetaminophen, aspirin, ibuprofen, or naproxen. 

Physical therapy will be a key part of your recovery.  The interventions you will perform are developed to help you regain your shoulder strength and range of motion. 

While the recovery from rotator cuff repair surgery can be a challenge, most people are back to their normal routine within 6 months.

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To schedule an appointment for physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045. To schedule an appointment with a Shoulder Orthopedic Specialist, please call 904-JOI-2000, schedule online or click below.

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