Rotator Cuff Repair

What are rotator cuff injuries?

There are four muscle-tendon groups that are responsible for stabilizing the shoulder joint and initiating movement in all directions. These muscles and tendons, collectively known as the rotator cuff, emanate from the scapula (shoulder blade) and attach to the head of the humerus (upper arm bone). Rotator cuff injuries are very common and can be caused by sports- or work-related activities, natural tendon deterioration, or bracing a fall onto an outstretched arm. Damage to the rotator cuff, if left untreated, can make performing normal daily activities difficult and painful.

What is the treatment for a rotator cuff injury?

Patients with minimal rotator cuff damage, such as incomplete or partial thickness tears, often benefit from non-surgical therapies. A combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs) can be used for symptom management. When appropriate, participation in a physical therapy program specifically tailored to the patient to restore motion and strengthen the rotator cuff is strongly recommended.

However, surgical intervention may be required when non-surgical therapies fail, or when patients sustain extensive rotator cuff damage such as a complete or full thickness tear. A minimally invasive surgical technique involving a small camera (arthroscope) and surgical tools are often all that is necessary to successfully repair rotator cuff injuries. Dr. Joseph D. Lamplot, orthopedic shoulder doctor, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who have experienced rotator cuff injuries and are in need of surgical repair.

What type of surgery is needed to repair a rotator cuff?

Dr. Lamplot typically performs an arthroscopic rotator cuff repair as an outpatient procedure. The patient is first placed under anesthesia and situated in a beach chair, or upright, position. When stabilized, a few small incisions less than half an inch are created surrounding the rotator cuff. The arthroscope (small camera) is inserted through one of these small incisions to methodically analyze the bones, muscles, tendons, and ligaments of the shoulder joint. Specialized surgical instruments are then introduced to excise and remove the injured tendon fragments and any other bone or tissue irregularities. The remaining healthy tendons are reattached in their original anatomic position on the humeral head. Rotator cuff injuries that result in a a complete tendon tear generally require special surgical anchors to secure the healthy tendon back to its anatomically correct location.

For most tears, Dr. Lamplot favors the double-row arthroscopic rotator cuff repair when surgically repairing rotator cuff injuries. This advanced surgical technique implements an additional row of suture anchors which has been shown to provide added stability to the tendon repair. The double-row technique also significantly decreases the risk of another tear that may result from increased stress on the repaired tendon. In patients with poor tissue quality, Dr. Lamplot may augment the repair with a collagen patch to improve the thickness of the repaired tendon.

What is the recovery period like after rotator cuff repair?

The recovery period following arthroscopic rotator cuff repair is contingent on the size of the tear, the tissue quality, and additional procedure performed at the time of surgery. The majority of patients can anticipate a full recovery in approximately 5-6 months, with continued improvement in rotator cuff strength and range of motion for a year or more. Patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL can expect the following during the recovery process:

• To ensure proper healing of the repaired tendons, an immobilization device (shoulder immobilizer) is applied to the repaired shoulder immediately after surgery.
• Passive range of motion exercises (i.e. not using the muscles of the surgical shoulder to initiate movement) generally begin within 24 hours of surgery and continue for approximately 6 weeks.
• The repaired tendons are evaluated around 6 weeks after surgery. Active range of motion exercises (i.e. using the muscles of the surgical shoulder to initiate movement) will begin at this point after clearance from Dr. Lamplot.
• The key to recovering from a successful arthroscopic rotator cuff repair is adhering to and completing the individualized physical rehabilitation program. This program involves working with a physical therapy team to regain a full range of motion and strengthen the muscles and tendons of the rotator cuff.

Rotator Cuff Tear Surgeon