The rotator cuff is the set of four tendons that help us move the shoulder. Technology has progressed over the past several years allowing surgeons to repair torn rotator cuff tendons through very small incision using advanced arthroscopic techniques. This is really on of my favorite procedures. A successful result depends on many factors including the size and age of the tear, preoperative function, the age of the patient, the number of tendons torn, the motivation of the patient and the experience of the therapist. The surgeon’s experience is also a crucial factor.
As surgeons, we depend heavily on technological advancements that enable us to repair a cuff arthroscopically. Below are some mpegs from a Smith and Nephew educational DVD.
Patient preparation:
Placement of medial row anchors:
Lateral hole preparation:
Placement of the lateral anchor achieving a double row repair:
Tensioning the sutures:
Completing the repair:
Even though we can repair the rotator cuff through small incisions, it still takes the same amount of time for the tendon to heal as it does when we make a standard incision. The tendon will heal to the bone in 6 – 8 weeks. Usually, we limit shoulder motion for at least 6 weeks permitting only passive home shoulder exercises during that time called pendulum exercises.
Shoulder strengthening is usually not permitted for 8 – 10 weeks. Typical patients are very functional at 12 – 16 weeks. Overhead work is permitted at 6 months and full recovery may take a year.
Thanks.
JTM, MD