Procedure for Repair of Shoulder Rotator Cuff

The rotator cuff surgery is a shoulder surgery, which includes reattaching the gathering of the four muscle tendons covering the arm bone (humerus) and helping in the rotation and lifting of one's arm.

Rotator cuff tears can happen during:

• Sports injuries in sports like baseball, tennis or any other sport involving lifting and throwing
• Normal wear and tear or doing repetitive jobs like cleaning windows, kneading dough or as a result of lifting heavy weights

The rotator cuff muscles tear could be complete or partial depending on whether the muscle tendon is completely or partially detached from the humerus.

What is the approximate cost of rotator cuff surgery in India?

In a private hospital or a corporate hospital the cost of surgery may vary from 1.5 to 2 lakh rupees. This does not cover the physiotherapy charges. Though minimal invasive arthroscopic rotator cuff repair may be priced slightly higher, the cost in terms of hospitalization and reduced post op complications compensates for the cost.

What is the average length of stay for rotator cuff surgery?

Arthroscopic repair is an outpatient (OP) procedure and patient can go home the same day. An open rotator cuff treatment requires upto 5 days depending upon the patient postoperative status.

Rotator Cuff Symptoms

Some commonly found torn rotator cuff symptoms are:

• Pain and inability to move the shoulder
• Difficulty in full movement at the joints
• Re-tear or chronic injuries may be asymptomatic except for mild stiffness

Indications for Rotator Cuff surgery

• Continued rotator cuff pain after non-surgical treatment
• Need to get back to active work very soon-for example in sportsmen or those needing to lift overhead weight as part of their jobs
• Acute injury
• Large tear
• Significant disability and loss of function .

Rotator Cuff Risks

• Poor tissue/tendon quality
• Large muscle tears
• Age factor
• Consumption of alcohol and drugs
• Smoking

What are the post-op complications

Immediate

1. Nerve injury can result rarely during the procedure especially in the open methods.

2. Deltoid detachment-The muscle that has been cut needs to be protected till it heals completely.

Early

Infection-Antibiotic coverage is usually required especially in the open surgical methods. Nowadays, with good infection control practices, it is becoming rare.

Delayed

• Stiffness-This can be minimized with good physiotherapy
• Re-tear -This may occur in people with large tears. However, it is rarely symptomatic and can be managed without surgery unless it is associated with severe pain or loss of function.

Post-operative care-

Good pain management, rotator cuff tear exercises and rest of the limb are required for the first 2 weeks during which passive physiotherapy is recommended to prevent stiffness.

Post discharge care/Rehabilitation information

8-12 weeks of good active physiotherapy should be done for complete recovery of the movements of the shoulder. Keeping active and following the doctors advise regarding exercise regimen is important:

Dos and Don'ts

• Smoking and alcohol to be avoided as it will delay healing
• Avoid lifting heavy weight
• Adherence to medication regime and physiotherapy is a must to regain lost function and prevent disability
• Do rotator cuff exercises regularly

FAQs

1. What happens if I leave a rotator cuff injury without taking treatment?

Answer - You may develop increasing stiffness and disability of your arm and shoulder, which may result in requirement of shoulder replacement.

2. I am a diabetic. Can I go in for surgery?

Answer - You certainly can, provided your blood sugars are under control. Infection risk in your case is high but it can be minimized with preoperative antibiotic coverage.