Last reviewed by Dr. Raj MD on January 12th, 2022.
Rotator cuff surgery is a procedure intended to repair a tear in the shoulder joint. The goal of the procedure is to restore the range of motion and function of the shoulder and the shoulder joint and to lessen or completely eradicate the symptom of pain. Rotator cuff surgery is indicated for patients with severe injury in the rotator cuff and when the symptoms of the disease still persist despite application of non-invasive treatment.
Various causes can result to injury in the rotator cuff which may necessitate a repair or surgery to correct the condition and to relieve the symptoms, thus providing comfort to the patient aside from the restoration of function and restoration of the range of motion of the shoulder. Injuries such as pain in the rotator cuff tendon, partial tear and full thickness tear of the rotator cuff are common injuries that may require rotator cuff surgery.
The rotator cuff is part of the shoulder that is responsible for controlling the movement of the shoulder joint. It is tough connective tissues and is made up of four tendons that work to stabilize the shoulder joint along with the other muscles that surrounds the tendons.
The movement of the shoulder joint, such as in elevating or rotating the arm is made possible by the group of muscles and tendons known as the rotator cuff. This part of the shoulder is made up of four muscles such as:
Supraspinatus is located on top of the spine of the scapula and is embedded in the greater tuberosity of the humerus. This muscle allows abduction of the shoulder joint or the elevation movement. The supraspinatus together with the other rotator cuff muscles is also responsible for stabilizing the head of the humerus in the shoulder joint.
Infraspinatus is a rotator cuff muscle that started off under the spine of the scapula particularly in the infraspinatus fossa and is attached to the posterior portion of the greater tuberosity of the humerus. This rotator cuff muscle allows external rotation of the shoulder joint including stabilization of the head of the humerus in the shoulder joint.
Teres minor is a rotator cuff muscle that is located on the border of the lateral scapula and is attached to the inferior portion of the greater tuberosity of the humerus. This rotator cuff muscle is also responsible for the external rotation of the shoulder and stabilization of the head of the humerus in the shoulder joint.
Subscapularis has been on the anterior surface of the scapula just above the ribs and is attached on the lesser tuberosity of the humerus. This rotator cuff muscle is responsible for lowering the head of the humerus to allow free movement of the shoulder joint and facilitate the arm abduction.
Rotator cuff surgery is performed by an orthopedic surgeon who specializes in the treatment of bone diseases and the connective tissues. The procedure can be done on an out-patient basis or may have the patient admitted in the hospital for a few days depending on the severity of the disease and the procedure performed.
Rotator cuff surgery is divided into two types according to the extent of a tear in the tendon and the two types are:
Partial tear repair is intended for a partial tear in the rotator cuff tendon, which usually begins with an inflammation. This type of rotator cuff repair is done by sprucing and smoothing the tendon.
Complete tear repair or is also called full thickness tear repair is a type of repair intended to complete tear. Complete tear is characterized by a complete detachment of the tendon from the bone. The goal of this type of repair is to reattach the tendon to the bone.
The rotator cuff surgery can be done with different approaches and which are basically done in the hospital or in a surgical setting. The patient can choose from the three options or approaches of rotator cuff surgery.
Open surgery is a more invasive approach of surgery that requires a large incision in the shoulder. The large incision is intended for easier viewing and access to the surgical site where the doctor can directly view and clearly perform the surgical procedure. This procedure however takes a longer time to heal or recover and causes a lot of pain compared to other approaches of surgery.
Minimally invasive surgery is a type of rotator cuff surgery that utilizes an arthroscope and specially designed instruments to be able to manipulate and perform the surgical procedure. The arthroscope along with the specially designed instruments is basically inserted to the rotator cuff through a small incision made on the shoulder. The procedure is performed with the surgeon viewing the inside of the shoulder through the small camera or the arthroscope. This approach requires a small incision in the shoulder, thereby causing less tissue damage.
Mini-open surgery is a combination of minimally invasive surgery and an incision which is smaller than the average size of open surgery. This approach utilizes newer technology and allows for a more extensive repair yet less tissue damage as the muscles need not be detached from the bone to perform repair.
The cost of rotator cuff surgery will depend on the type of surgery and the region of the globe where the surgery is performed. The cost of the surgery will include the medicines, the facility and including the cost or the professional fee of the surgeon who performed the procedure. The type of care is also considered in the cost of the procedure.
The recovery time for rotator cuff surgery depends on the type of surgery performed and the extent of damage or injury to the rotator cuff. Generally, recovery time may take three to six months, depending on the severity and extent of injury.
The shoulder is basically immobilized right after the surgery and is done by putting a sling on the shoulder of the patient to keep it from moving. The sling may have to be worn for four to six weeks or depending on the extent of the injury in the shoulder and the rotator cuff.
Restoration of the structure and function of the shoulder may take several weeks or months, depending on the type of surgery or the approach of surgery performed. Physical therapy on the other hand can help in the restoration of strength and regaining the range of motion of the shoulder.