Rotator Cuff Surgery

What is rotator cuff surgery?

Rotator cuff surgery is the surgical repair of a damaged rotator cuff tendon. The rotator cuff tendons control the motion of your shoulder joint. Your shoulder joint is formed where your upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle) meet. A group of four muscles surround these bones to form your rotator cuff. These muscles attach to the humerus by tendons. Tendons are tough pieces of connective tissue. Rotator cuff surgery can potentially help restore pain-free range of motion and full function in a damaged shoulder joint.

Rotator cuff tears are common. Not all rotator cuff tears require surgery. Rotator cuff surgery is a major surgery with serious risks, a long recovery, and potential complications. You may have less invasive treatment options depending on your specific circumstances. You should consider getting a second opinion about all your treatment choices before having rotator cuff surgery.

Types of rotator cuff surgery

The types of rotator cuff surgery include:

• Complete tear or full-thickness tear repair. A complete tear is when your tendon detaches completely from the bone. Your surgeon will reattach your tendon to the bone.
• Partial tear repair or debridement. Partial tears often begin with fraying and inflammation of your tendon. Your surgeon may only need to trim and smooth your tendon for this type of repair.

Other procedures that may be performed

In addition to rotator cuff surgery, your doctor may perform one or more additional procedures to treat certain co-existing conditions. These include:

• Bone fracture or dislocation repair. Certain severe injuries can cause rotator cuff tears requiring surgical repair of both the tear and the injury. These injuries include a fractured collarbone, a fractured humerus, and shoulder dislocations.
• Bursectomy or bursa sac repair is a procedure that your doctormay recommend to treat a damaged bursa sac, which can occur with a damaged tendon. Your bursa sac provides cushioning for your joint.
• Shoulder replacement is a procedure that your doctor may recommend to treat osteoarthritis of your shoulder. Shoulder replacement can involve a partial replacement of just one part of your bone or a total replacement of your entire shoulder joint.
• Soft tissue repair is a procedure to treat damage to the muscles in your shoulder.

Why is rotator cuff surgery performed?

Rotator cuff surgery is a major surgical procedure that your doctor may recommend to treat a damaged rotator cuff. Your rotator cuff is a group of muscles and tendons that surround your shoulder joint and allows you to lift your arm and rotate your shoulder. Rotator cuff damage is often caused by aging, overuse or injury. This can result in a tendon tear, tendinosis (degeneration), tendonitis (inflammation of your tendon), and bursitis (inflammation of your bursa sac).

Your doctor may only consider rotator cuff surgeryfor you if other treatment options with less risk of complications have been ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend rotator cuff surgeryif your tendon tear is:

• Caused by a recent injury
• Causing loss of function in your shoulder
• Causing symptoms, such as pain, that last for six to 12 months
• Larger than three centimeters (cm), or a little more than an inch
• If non-surgical management fails and you deem your quality of life to be poor.

How is rotator cuff surgery performed?   

An orthopedic surgeon will lead the surgical team and perform your rotator cuff surgery in a hospital or outpatient surgical setting. An orthopedist is a surgeon who specializes in surgical treatment of diseases of the bones and connective tissues.

Surgical approaches to rotator cuff surgery

Rotator cuff surgery may be performed using one of the following approaches:

• Minimally invasive surgery is a procedure performed by inserting special instruments and an arthroscope through small incisions in your shoulder. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery.