Rotator cuff repair may be needed in the following cases:
- Overuse of shoulder in sports.
- Continuous shoulder pain during rest. No improvement may be shown even after exercises.
- A significant rotator cuff tear. The tear may be 3cm long or much longer.
- Inability to perform everyday activities.
Surgical treatment of rotator cuff can be performed either by open repair, all-arthroscopic repair or mini-open repair.
Obviously, the open surgery procedures take time to heal. Microscopic procedure like all-arthroscopic repair however can be done in minimal time with minimal invasion.
4 to 5 small incisions are made around the shoulder. The procedure begins with initial evaluation of the shoulder and insertion of an arthroscope through a small hole. The area of rotator cuff is examined and bone spurs (if any) are removed. A larger incision may be used to repair the tear, if it can be repaired. The main objective is place the tendon to the place from where it tore off. This is done with the help of sutures and rivets.
The procedure includes the following steps:
- The tear is examined through the arthroscope and provision for instrument insertion is made.
- Using a suture passer, a suitable suture is now passed across the long limb of the tear.
- The tendon ends are tied together and the suture is tied.
- Preparation of the bone is done for the suture anchor insertion.
- Insertion of the suture anchor is done with the help of a long insertor. After this, the insertor is removed.
- By using a suture retrieving forceps, suture is pulled from the anchor through the tendon. The anchor sutures are now passed across the rotator cuff tendon.
- After passing the sutures, they are tied.
The period taken for rehabilitation is generally 6 months.