Risk of Rotator Cuff Surgery
The rotator cuff is composed of a group of four tendons and the muscles associated with stabilizing the shoulder joint and allow rising and rotation of the arm. When these tendons are torn through an accident or injury, it's often possible to perform a repair. The goal of this surgery is to allow smooth movement of the upper arm bone over the shoulder and align with the shoulder blade. This surgery isn't without risk, however.
Risks
In some extreme cases the rotator cuff tendon may be irreparable due to the severity of the tear and not be eligible for surgery at all. Besides risks associated with anesthesia during surgery, there is significant risk of injury to nerves and blood vessels during the surgical process. Infection is possible, as is increased pain or stiffness of the joint from inflammation following surgery. There is also an increased risk of re-tearing after initial surgery, which can lead to the need for further surgeries.
Managing Risk
Many risks are reduced with proper management during surgery. Washes prior to surgery and proper antibiotic treatments reduce the risk of infection greatly. Stiffness and pain are managed with pain medicines and physical therapy, and blood vessel and nerve injuries can often be protected against or repaired with further surgery. The risk of re-injury and further surgery is mostly up to the patient and their diligence in following through with physical therapy, and exercising proper care in daily activities.
Surgery
Surgery for the rotator cuff most commonly involves making an incision in the shoulder to open it and see the shoulder bones during repair. A surgeon begins the process of removing loose fragments of tendon or other debris from the space in the shoulder where the rotator cuff moves. This allows more room for the tendon and reduces the risk of pinching or irritation. If necessary, surgery will call for some of the bone to be shaved away or the removal of bone spurs. Finally, any torn edges of tendon are sewn back together and to the top of the upper arm bone.
After Surgery
Pain medications are prescribed after surgery to decrease discomfort. A sling is also worn for a period of time to aid in healing and protect against further injury. Almost immediately upon waking from anesthesia, exercises begin to flex and extend the hand, wrist, and elbow. Twenty-four hours later, passive arm exercises begin and continue until starting with a physical therapist after six to eight weeks, and 60 days after surgery light weightlifting begins to strengthen the shoulder area.
Effectiveness
An accomplished surgeon can effectively restore comfort and function to the shoulder of a patient who is willing to follow through with physical therapy. With proper strengthening and muscle retraining, and when care is taken to avoid subsequent injuries, the benefit can last for decades and allow for normal active living.
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