Athroscopic Rotator Cuff Surgery
The rotator cuff is a group of 4 muscles and tendons around the shoulder that are important for the shoulder to function normally. Tears frequently occur in older age and can lead to pain and dysfunction in the shoulder by unbalancing the force couples that drive shoulder movement. Full thickness rotator cuff tears never heal on their own. However most small tears, particularly of supraspinatus, can be treated nonoperatively with appropriate physiotherapy, pain management, and 1 or 2 corticosteroid injections. Up to 90% of patients treated this way will have no pain and return of most shoulder function by 12 months. If non operative treatment has failed to improve your pain and function after 3-6 months, surgery is likely to be indicated.
For some rotator cuff tears early surgery is the best form of treatment without a trial of non operative treatment. These include traumatic cuff tears, particularly when the patient has a pseudoparalysis (inability to perform normal shoulder movements afterwards), and full thickness tears in physiologically young patients (<55) due to the unacceptable rates of tear progression and higher likelihood of successful tear healing following surgery.
Arthroscopic (keyhole) rotator cuff surgery is performed through multiple small incisions used as portals for an underwater camera and instruments. Occassionaly a mini-open incision may also be required for complex cuff tear configurations. During surgery the identified rotator cuff tear will be repaired as well as any other pathology that is identified to be causing pain or other symptoms. This commonly includes removing subacromial spurs that are causing impingement (“rubbing on the rotator cuff”), painful acromioclavicular joint arthritis, and long head of biceps tendinopathy in the shoulder joint.
Unfortunately the rehabilitation phase after cuff tears is longer than most patients would like. Tendon healing onto bone takes 12 weeks to complete and during this time it is highly recommended that all patients refrain completely from smoking. A sling is usually required in the first 6 weeks with a coordinated physiotherapy program starting at 4-6 weeks post operatively that we will personalize for you.
This is general information only and if you would like to talk to Dr Hamish Rae, one of the best orthopaedic surgeons in Sydney, about your shoulder pain and options for treatment please call 80055111 to make an appointment.