We understand that staying active is important to many people. Whether you play sports, spend time gardening or enjoy walking, movement is key to a healthy lifestyle. If shoulder pain is affecting your activities and you need rotator cuff surgery, the shoulder experts at The Ohio State University Wexner Medical Center in Columbus, Ohio, can help. The orthopedic and sports medicine teams will guide you through the shoulder surgery and if necessary, repair your shoulder so that you can enjoy your favorite activities.
What is rotator cuff surgery?
The rotator cuff is a group of muscles and tendons in your shoulder that help you move your arm. This surgery fixes rotator cuff tears in these muscles and tendons to make your shoulder work better and reduce pain.
The shoulder joint is a “ball-and-socket” joint comprised of muscles, other soft tissues like cartilage and tendons and three bones. Those three bones are the:
- Upper arm bone (humerus)
- Shoulder blade (scapula)
- Collarbone (clavicle)
The rotator cuff consists of four muscles and tendons that allow the “ball” (humeral head) to rotate against the “socket” (glenoid fossa). The rotator cuff surrounds the shoulder joint.
The muscles and tendons in the joint keep the shoulder steady and allow it to move. When the rotator cuff tears, it usually does so at the top rotator cuff tendon (called the supraspinatus). However, any (or all) of the rotator cuff’s four tendons can also tear. When any part of the rotator cuff is injured or torn, it can cause pain and restrict your mobility. When this happens, a shoulder specialist will evaluate your individual condition to determine whether surgery is needed.
Do you need surgery for a torn rotator cuff?
Whether you’re a candidate for surgery or not will be dependent on many factors. Some factors may include:
- Severity of the rotator cuff injury
- Size and location of the tear
- Ongoing, persistent pain that lasts for several months or interferes with activities
- Age and overall health status
- Whether you have improved with physical therapy
Our team of doctors will help you understand the risks and benefits of your treatment options so that you can make an informed decision about your care.
How is rotator cuff surgery performed?
There are different types of rotator cuff surgery, but your doctor will determine which one you’ll need.
Rotator cuff surgery is usually performed arthroscopically. You will be asleep for the duration and in most cases, will also receive a nerve block prior to the start of surgery. This will help ensure adequate pain control after the procedure. An arthroscope is a thin tube with a small camera and a light at the end of it, and this allows a surgeon to examine the rotator cuff and surrounding shoulder area. The surgeon will insert the arthroscope into the shoulder using small incisions. Images of the area are projected onto a screen to explore the rotator cuff and other nearby tissues. If repairs are needed, your doctor will make them by using specialized tools passed through the small incisions.
Since the incisions made during arthroscopic surgery are small, the procedure is less invasive, causing less damage to the surrounding tissues. This often results in less pain after surgery and a quicker recovery. Most arthroscopic rotator cuff surgeries are done in an outpatient setting, which means you can usually go home the same day as the procedure.
In some cases, an open repair surgery might be needed. Open repair surgery involves making larger incisions to fully access the shoulder joint and repair the rotator cuff. Although it isn’t as common as arthroscopic surgery, open repair can be necessary for more severe tears or complicated conditions.
Often, when people have rotator cuff surgery, they may not only have a torn rotator cuff, but other conditions present in the shoulder too. This could include conditions like osteoarthritis or biceps tendonitis. Surgeons can usually fix these issues while performing rotator cuff repair. If diagnostic imaging confirms these conditions, your doctor may perform more than one procedure to complete the repairs needed during your surgery.
Typically, rotator cuff surgery lasts between one to two hours but will be dependent on the severity of repairs and other factors.
What to expect after rotator cuff repair
Recovery after rotator cuff surgery will be different for each person. However, proper rehabilitation is key to achieve the desired treatment outcomes and to regain full use of the arm. This usually follows a phased approach.
In the short term, you'll be in a sling (provided to you after surgery) for at least four to six weeks (your doctor will tell you the exact duration) to immobilize the shoulder and restrict movement. This ensures proper healing of the rotator cuff and your safety.
Pain is expected after surgery. Your doctor will work with you to control your pain through medications and other pain-relieving techniques, such as with ice machines, which are usually provided to you upon discharge. You may also have trouble sleeping. Your care team will help you figure out how to sleep more comfortably, which may include sleeping upright in a recliner or propped up in a bed with wedge pillows. Our team can help you find what works best for you.
Driving restrictions will be in place until you're off all narcotics and can safely operate a vehicle. You will need to arrange a ride home from surgery and will be unable to drive for a certain period. Your doctor will also discuss other activities with you and when you can resume them safely.
Physical therapy will also be a key component of your recovery to strengthen the rotator cuff. Upon discharge, you’ll receive instructions for basic at-home exercises that you can complete on your own. You’ll be scheduled for outpatient physical therapy in the weeks following your procedure.
Your doctor will provide specific postoperative instructions for you upon discharge with additional information outlining specific tasks.
How long does it take to recover from rotator cuff surgery?
The time it takes to recover from a rotator cuff surgery will be dependent on a variety of factors.
Full recovery from a rotator cuff repair can take four to six months or longer. Your doctor will discuss other factors that will affect your recovery, especially if you’ve had multiple other procedures.
Risks of this procedure:
Like all medical procedures, there are some risks associated with rotator cuff repair.
Some risks may include:
- Excessive bleeding or blood clots
- Postsurgical infection
- Injury at the surgical site (such as to tendons or muscle)
- Allergic reactions to medications used during the procedure
- Anesthesia complications
While these risks are minimal, your care team, including surgeons and the anesthesia team, will communicate these to you in advance of the procedure.
If you have specific questions, be sure to talk to your doctor.
Why choose Ohio State shoulder surgeons for your rotator cuff repair
At the Ohio State Wexner Medical Center, our shoulder surgery team is highly experienced in rotator cuff repairs. They use the latest surgical techniques to ensure the best outcomes for you.
Our multidisciplinary approach means that experts from different fields work together to provide comprehensive shoulder care.
The shoulder team receives the latest in surgical training techniques. They also speak regularly at academic medical conferences to share the latest in research. This dedication helps our surgeons continually refine their techniques and provide you with the best care.