As with any surgical procedure, complications can happen. Some possible complications may include:
- Blood clots
- The joint pain and weakness may not be relieved by the surgery. You may not recover full range of motion in the shoulder joint.
- Nerves or blood vessels in the area of surgery may be injured. This results in weakness or numbness.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
Also, it is very important to follow all of your doctor’s instructions to make sure that your shoulder fully heals and shoulder problems don’t return. You will likely need to do physical therapy and other exercises to help your shoulder fully heal.
Rotator cuff repair surgery can restore use of the shoulder and reduce pain. Mini-open rotator cuff surgery uses smaller incisions than open surgery, and the surgeon does not detach the large deltoid muscle. This results in less risk and recovery time. Most patients see improved shoulder function, as well as increased strength and range of motion.
Your doctor will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
In addition to a complete medical history, your doctor may perform a complete physical exam to make sure that you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
- Tell your doctor if you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents (local and general).
- Tell your doctor of all medicines (prescribed and over-the-counter), patches and herbal supplements that you are using.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. It may be necessary for you to stop these medicines before the procedure.
- Tell your doctor if you are pregnant or suspect that you are pregnant.
- Be sure to follow your doctor’s instructions about when to stop eating and drinking before surgery.
- Arrange for a responsible adult to drive you home and stay with you the first day.
You may meet with a physical therapist before your surgery to discuss rehabilitation. Based on your medical condition, your healthcare provider may request other specific preparation.
Rotator cuff repair may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.
Rotator cuff repair may be done while you are asleep under general anesthesia, or while you are awake under local or regional anesthesia. If regional anesthesia is used, you will have no feeling in your shoulder. The type of anesthesia will depend on the specific procedure being done. Your healthcare provider will discuss this with you in advance.
Generally, rotator cuff repair surgery follows this process:
- You will likely be given general anesthesia so you are asleep and feel no pain. Some people get regional anesthesia that just numbs the shoulder area. In this case you would also be given another medicine to make you sleep during the surgery.
- The skin over your surgical site will be cleansed with an antiseptic solution.
- Your surgeon will make an incision in the shoulder area and insert the arthroscope. Other incisions may be made to introduce other small grasping, probing, or cutting tools.
- Bone spurs (if present) will be removed.
- Injured tendons and muscles will be repaired or replaced with a graft tendon from another part of the body. Stitches and small rivets may be used to help attach a new tendon to the bone. These will dissolve over time and don't need to be removed.
- The incision(s) will be closed with stitches or surgical staples.
- A sterile bandage or dressing will be applied.
- After the surgery, the arm is usually placed in a sling. You will need to go to physical therapy to regain full range of motion and increased shoulder strength.
Your doctor will schedule follow-up appointments with you depending on the severity of damage. In many cases, your arm may be in a sling for a month or longer. Recovery times vary. Talk to your doctor about what you can expect for recovery to better understand what a mini-open rotator cuff procedure will look like for you.
The success of this procedure depends in part on how well you focus on recovery. It is very important that you follow your doctor’s instructions very closely to help reduce the risk of infection or the return of shoulder problems.
You may be given an immobilizer or sling before you go home. Once you're home, it's important to keep the surgical area clean and dry. Your healthcare providers will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
Your healthcare providers will recommend pain medicines to use during recovery. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.
To help reduce swelling, you may be asked to apply an ice bag to the shoulder several times per day for the first few days. You should keep the sling or immobilizer on as directed by your healthcare provider.
Your healthcare provider will arrange for an exercise rehabilitation program to help you regain muscle strength, flexibility, and function of your shoulder.
Notify your healthcare provider to report any of the following:
- Fever or chills
- Redness, swelling, bleeding, or other drainage from the incision site
- Increased pain around the incision site
- Numbness or tingling in the affected arm or hand
You should not drive until your healthcare provider tells you to. Other activity restrictions may also apply. Full recovery from the surgery may take several months. Your healthcare provider may give you additional or alternate instructions after the procedure, depending on your particular situation.
If is important that you follow your doctor's instructions to protect the repair site to make sure that it heals as quickly as possible. Soft tissue-to-bone healing can be slow. Pressure and tendon immobilization can help speed up the repair. Talk to your doctor about how to healthily apply pressure and immobilize your tendons to speed up your healing.
Make sure to take your medicines exactly as directed by your doctor. If your doctor has prescribed a pain medication, it may cause constipation. If you find that you become constipated, you may need to take a stool softener to help alleviate the discomfort. Constipation is a normal side effect to some pain medications. Talk to your doctor if you have additional questions or concerns.
Soon after surgery, your surgeon and physical therapist will give you exercises to help you get back to your daily routine. These exercises will increase your ability to move your arm and increase your strength. It is very important to do these exercises as directed so your shoulder heals well. Here's what you can expect:
- At first, your exercises will be mild and limited to very gentle arm movements
- As you get stronger, you will start to move the affected arm with the help of your other arm. This will help increase the mobility and range of motion of your new shoulder. These exercises will continue for several weeks
- You will need to keep your arm in a sling for several weeks and possibly more than a month
- Take several short walks each day to help your body heal
- You will not be able to drive for 2 to 4 weeks after your surgery. DO NOT DRIVE when taking opioid pain medicine. Ask someone to take you to your appointments, if needed.
Eat a well-balanced diet that includes lots of fresh vegetables, fruits, fish, and lean meats. Your body needs good nutrition for healing. Drink lots of water. This will help with constipation. Avoid beverages with added sugar or alcohol. Never drink alcohol when taking opioid pain medicines.
The rotator cuff consists of muscles and tendons that hold the shoulder in place. It’s one of the most important parts of the shoulder, as it lets you lift your arm and reach up. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand, or it can develop over time due to repetitive activities. Rotator cuff degeneration and tears may also be caused by aging. Other problems in the rotator cuff can result from inflammation in the bursa or other tissues.
Tears in the rotator cuff can lead to a variety of shoulder problems, and may become very painful. In some cases, rotator cuff tears can even lead to debilitating shoulder dysfunction and impairment.
If your rotator cuff is injured and nonsurgical treatments have not helped, you may need to repair it with surgery. The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve pain. This may include shaving off bone spurs that are pinching the shoulder, or repairing torn tendons or muscles in the shoulder.
Surgical techniques that may be used to repair a tear of the rotator cuff include:
- Open repair. The surgeon makes an incision over the shoulder and detaches the large muscle (the deltoid). This helps them see the rotator cuff and get to the torn tendon. This approach is usually used for large or complicated tears.
- Arthroscopic repair (ahr-THROW-skahp-ik). One to 3 very small incisions are made and tiny tools are inserted through a scope. A video image of the surgery is projected on a screen so the surgeon can see inside the shoulder.
- Mini-open repair. The surgeon uses arthroscopy to assess the joint and possible repair bone spurs or other problems. Then another small incision is made to repair the rotator cuff. The surgeon sees the tissues directly at this point, and not on a screen.
The success of this procedure is not only in how well the procedure is performed, but how well you focus on recovery. With this procedure, it is very important that you follow your doctor’s instructions very closely to help reduce the risk of infection, or even the return of shoulder problems.