Rotator Cuff Repair Overview
Rotator cuff tears can be partial or complete. Partial tears sometimes will heal with physical therapy and platelet-rich plasma (PRP) injections, although not always. Complete rotator cuff tears rarely heal, and usually when there is pain or weakness, it is our preference to repair the tissue, rather than permit it to go on to atrophy. Our surgical repair technique involves bringing the patient to the outpatient surgery center and under a local regional block, viewing the rotator cuff arthroscopically, placing sutures and suture anchors into the bone, and then repairing the torn rotator cuff back to its normal insertion site.
Rotator Cuff Repair Patient Experience
Rotator Cuff Surgical Technique
If the cuff tear is significant, surgery is generally recommended in order to prevent the humeral head from poking up through the rotator cuff tear to rub against the bony acromion. This superior migration not only produces pain and limited motion but leads to significant arthritis of the shoulder joint. At surgery, the torn cuff is sewn back to itself, and reattached to the bony insertion on the lateral border of the humerus. Fortunately, many times this can be performed arthroscopically (using a small incision through which a thin tube is inserted to do the procedure). We routinely repair torn rotator cuffs under local (regional anesthesia with the patient awake) as an outpatient (no overnight stay required). Exercises are started the next day and the patient usually can return to full activities within months.
Rotator Cuff Repair Rehabilitation
Over the past few years, the rehabilitation of rotator cuff repairs has dramatically changed due to the fact that the anchoring and suturing techniques have vastly improved so that Brostrom repairs are now possible and early shoulder mobilization, rehabilitation, and strengthening exercises can be performed. Most commonly, the patient uses a sling for one month after surgery in order to diminish the chance of overloading the shoulder; however, physical therapy is started on the first day after surgery. Range of motion pool exercises are initiated very early in order to diminish the chance of the shoulder developing stiffness as well as to increase the chance of full strength and recovery of the torn tissue.
The team at The Stone Clinic has been repairing rotator cuffs for over 20 years and has progressively improved the techniques. In the early 1990’s, Dr. Stone invented one of the first suture anchors designed for rotator cuff repair, called the Questis suture anchor. He has been involved in technique design, modifications, and improvements ever since. Due to his confidence in the ability to repair the rotator cuff in a stable fashion, he has been comfortable pushing the rehabilitation program in ways that specifically protect the rotator cuff during the healing period but permit range of motion and strengthening exercises to be performed under the careful guidance of the extremely experienced rehabilitation team at The Stone Clinic.
The Stone Clinic
Building Better Joints Through Advanced Techniques in Cartilage Replacement, Regeneration and Repair