The rotator cuff is a group of four muscles in the shoulder and upper arm. The muscles help to move the arm at the shoulder and also help to stabilize the joint. The muscles are connected to the shoulder bone by tendons, which are strong, flexible cords. Tendons may become damaged from long term overuse or from injury.
A rotator cuff repair is a surgery to repair damage to the rotator cuff.
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Your doctor may recommend this surgery for:
- A rotator cuff injury which does not respond to rest and physical therapy treatment.
- A complete tear in the tendon.
- Chronic pain and weakness from a partial tear in the tendon.
Complications are rare but no procedure is completely free of risk. If you are planning to have this repair, your doctor will review a list of possible complications which may include:
- Infection
- Bleeding
- Scarring within the shoulder joint
- The operation does not provide the desired improvement in function
- Reaction to anesthesia
Your doctor may do the following:
- Physical exam
- Blood tests
- A x-ray of the shoulder
- An MRI of the shoulder—a test that uses magnetic waves to make pictures of structures inside the body
Leading up to the procedure:
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Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Do not eat or drink anything for at least 8 hours before surgery.
- Arrange for a ride to and from the procedure.
General anesthesia is typically used. You will be asleep.
There are two methods used to perform a rotator cuff repair:
The surgeon will make a large cut in the skin over the shoulder. The torn tendon will be repaired and reattached and/or anchored with stitches. The incision will then be closed with stitches or staples.
A few small incisions will be made in the shoulder. A narrow tool called an arthroscope will be inserted through the incision. The scope has a tiny camera to allow the surgeon to see inside. Other small instruments will be inserted through the other incisions. The surgeon will use these tools to repair the tendon.
After either procedure the incisions will be bandaged. Your arm will be placed in a sling. The sling will prevent movement while you heal.
About 1 ½-2 hours
Anesthesia prevents pain during the procedure. You may have some discomfort immediately after. Your doctor can give you medicine to help manage this.
You may be able to go home the same day. Some may need to stay in the hospital for one day.
When you return home, do the following to help ensure a smooth recovery:
- Use ice to reduce swelling during the first 24-48 hours after surgery.
- Take the full doses of all medicines prescribed.
- Keep the bandage clean and dry at all times.
- Do not use the arm until instructed. Where the sling as directed.
- Unless your job requires heavy lifting, you can usually return to work within a few days after surgery.
- Follow instructions for physical therapy. Therapy is essential to regain shoulder strength and range of motion.
- Be sure to follow your doctor's instructions.
The rotator cuff will take several months to heal. It may take some time before you can raise your arm above your shoulder. It may be up to one year before you can hold your arm above your head and do work with reasonable strength. An aggressive and consistent exercise program is the key to a faster recovery.
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- The stitches or staples come apart
In case of an emergency, CALL 911.
Last reviewed November 2009 by Robert E. Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.