Rotator Cuff Repair

What is the Rotator Cuff?

The shoulder joint has a system of tendons and muscles that surround the shoulder called the rotator cuff that gives it stability and an incredible range of motion. The rotator cuff is made up of four muscle-tendon units that insert onto the humeral head.  The muscles attach to the bone through their respective tendons.

The main function of the rotator cuff is to guide and initiate the movement of the shoulder joint.  Because these tendons are at a mechanical disadvantage – especially when lifting something overhead or engaging in overhead sports – injuries to these tendons are common.

An injury to the rotator cuff can range from mild inflammation of the tendon, to a partial or complete tear. Dr. Armando Vidal, shoulder surgeon, can diagnose and treat rotator cuff injuries for patients in Vail, Aspen and the surrounding Denver, Colorado areas, returning them to their active lifestyle.

How is a rotator cuff repaired?

Any of the tendons making up the rotator cuff can tear, with the most common tendon being the supraspinatus muscle/tendon. When this occurs, the tendon no longer fully attaches to the head of the humerus and the shoulder will lose its strength and stability. The most common complaint though is pain.  This pain usually radiates into the deltoid and down the arm (sometimes as low as the elbow) and is often associated with night pain.  The goal of a rotator cuff repair is to reattach the tendon and restore the strength and stability of the shoulder joint. Depending on the type of tear, there are different treatments options to repair a torn rotator cuff.

Non-Surgical Treatments:

Initial non-surgical management of chronic, degenerative rotator cuff tears is the standard of care.  Non-surgical rotator cuff treatment can improve function and relieve pain and has been shown to be effective in up to 85% of appropriately indicated patients. The most effective and proven intervention for relieving pain from rotator cuff disease is physical therapy. Dr. Vidal may additionally prescribe rest, activity modification and non-steroidal anti-inflammatory medication to help alleviate pain. When appropriate, corticosteroid injections can be helpful however, these types of injections are not for every patient or every type of rotator cuff tear. These injections are typically prescribed to relieve pain to allow a patient to effectively rehabilitate the injury.

Despite the success of non-operative management, it is not always the right intervention for all patients.  In general, younger patients and patient with acute, traumatic rotator cuff tears are better candidates for surgical repair.

Surgical rotator cuff repair. What is arthroscopic rotator cuff repair?

If non-surgical techniques do not alleviate pain, or if the tear in the rotator cuff is felt to be better treated with surgery, arthroscopic repair is necessary. Arthroscopic rotator cuff repair uses a small surgical camera called an arthroscope. The camera is inserted into the shoulder through a small incision and displays pictures on a television screen so Dr. Vidal can “see” inside the joint. He uses the images to guide small surgical instruments, inserted through other small incisions. The arthroscopic rotator cuff repair is completed within the shoulder, reducing the risk of post-operative complications. Minimally invasive surgery also speeds up healing time and reduces the risk of muscle injury and muscle stiffness.

What is done during arthroscopic rotator cuff surgery?

If the tear is partial, Dr. Vidal may only need to perform a smoothing and trimming procedure called a debridement. Complete rotator cuff tears involve re-attaching the torn tendon to the original site on the head of the humerus. The repair is done by using special surgical anchors that are secured within the bone. The anchors are attached to strong sutures which are used to sew the tendons down to the original attachment site on the bone. It is important to maintain the original footprint and reattachment is very specialized. Patients in Vail, Aspen and the surrounding Denver, Colorado communities know that Dr. Vidal has the kind of experience and expertise in repairing even the most complicated rotator cuff tear.

What is the recovery like after a rotator cuff repair?

The average patient undergoing a rotator cuff and in good health can expect a 4-6 months healing time. Patients in Vail, Aspen and the surrounding Denver, Colorado communities can expect the following:

Phase 1 – Healing Phase (Weeks 0-6)

• The arm is placed in a sling, directly after surgery to protect the healing tendon.
• Passive range of motion exercises begin the day after surgery under the guidance of a physical therapist. This is when someone other than the patient moves the arm to maintain flexibility. Passive motion usually lasts about 6 weeks.

Phase 2 – ROM / Mechanics (Weeks 7-12)

• Active motion exercises typically being around week 7, depending on the healing progress of the patient and tear characteristics.
• The focus of this phase to regain motion and to restore normal mechanics and scapula-humeral rhythm to shoulder joint function.

Phase 3 – Strength / Function (Weeks 13-24)

• Strengthening exercises typically begins around 3 months – depending on tear size.
• Patients with full-thickness tears usually recover in about 4-6 months with continued improvement for a year or more after a successful repair.

Patients experience greater success and a full return to their favorite activities when they are willing to follow the advice and guidelines given by Dr. Vidal.

Rotator Cuff Restoration Surgeon

Have you experienced shoulder pain due to wear-and-tear, or a traumatic injury? If so, you may be a candidate for arthroscopic rotator cuff repair. The rotator cuff tends to wear down with time, either becoming damaged or torn causing pain and a decreased range of motion. Arthroscopic shoulder surgeon, Doctor Armando Vidal provides diagnosis as well as arthroscopic surgery for patients in Vail, Aspen, and the surrounding Denver, Colorado communities who have experienced a rotator cuff injury. Contact Dr. Vidal’s team today!