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Surgery may be used to treat a
rotator cuff disorder if the injury is very severe or
if nonsurgical treatment has failed to improve shoulder strength and movement
The rotator cuff is a group of four tendons and the related muscles
that stabilize the
shoulder joint and allow you to raise and rotate your arm. The shoulder is a
ball-and-socket joint with three main bones: the upper arm bone (humerus), the
collarbone (clavicle), and the shoulder blade (scapula). These bones are held
together by muscles, tendons, ligaments, and the joint capsule. The rotator
cuff helps keep the ball of the arm bone seated into the socket of the shoulder
Surgery to repair a torn rotator cuff tendon usually
In open shoulder surgery, a surgeon makes an incision [2 in. (5 cm) to
3 in. (7.6 cm)] in the shoulder
to open it and view the shoulder directly while repairing it. A smaller
incision can be done with a mini-open procedure that allows the surgeon to
reach the affected tendon by splitting the deltoid muscle. This method may
reduce your chances of problems from a deltoid injury.
Open-shoulder surgery often requires a short stay in the
General anesthesia or a
nerve block may be used for these types of surgical
Rotator cuff tears can sometimes be repaired with
Discomfort after surgery may decrease with taking pain medicines
prescribed by your doctor.
The arm will be protected in a sling for a defined period of time,
especially when at risk of additional injury.
Physical therapy after surgery is crucial to a successful recovery.
A rehabilitation program may include the following:
Surgery to repair a rotator cuff is done when:
Rotator cuff repair surgery for a tear from a sudden injury works
best if it is done within a few weeks of the injury.1 But repairs of very large
tears are not always successful.
Rotator cuff surgery to repair frayed or thinned tendon tissue is
less likely to work than surgery to repair an injury to a healthy
In addition to the risks of surgery in general, such as blood loss
or problems related to anesthesia, complications of rotator cuff surgery may
Very large tears [greater than
2 in. (5 cm) or involving more
than one rotator cuff tendon] often cannot be repaired.
Grafting and patching procedures are possible. But
they are not much better at restoring strength than debridement and smoothing,
which are less risky and require less rehabilitation.
Less active people (usually those older than 60) with confirmed
rotator cuff tears that do not cause pain, significant weakness, or sleep
problems can safely go without surgery unless symptoms get worse.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Rotator
cuff tears. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 311–316. Rosemont, IL: American
Academy of Orthopaedic Surgeons.
Other Works Consulted
Beasley Vidal LS, et al. (2007). Shoulder injuries. In
PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 118–145. New York: McGraw-Hill.
Devinney DS, et al. (2005). Surgery of shoulder
arthritis. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions, 15th ed., vol. 1, pp. 995–1015. Philadelphia:
Lippincott Williams and Wilkins.
Husni EM, Donohue JP (2005). Painful shoulder and
reflex sympathetic dystrophy syndrome. In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions, 15th ed., vol. 2, pp.
2133–2151. Philadelphia: Lippincott Williams and Wilkins.
Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al.,
eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986–1015. Philadelphia: Saunders Elsevier.
Murphy RJ, Carr AJ (2010). Shoulder pain, search date August 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
November 30, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Timothy Bhattacharyya, MD
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