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What to expect with your rotator cuff repair surgery

By Gloria Cunningham,2014-04-30 00:52
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What to expect with your rotator cuff repair surgery

    Rotator cuff repair surgery.

    Douglas H. Murray, MD

    Peachtree Orthopaedic Clinic

Before Surgery:

    - Not everyone with a torn rotator cuff has to have surgery (depending on the type of tear as well as the patient’s age and activity level). Remember that rotator cuff surgery

    is not an emergency. Your surgery should be scheduled at a time that is convenient for you to have time after surgery to recover and work on rehabilitating your shoulder. Most (but not all) repairs can be delayed for several months, if necessary, to accommodate your schedule.

    -Continue to work on the motion in your shoulder up until the day of surgery by lifting your arm up over your head and across your body to prevent stiffness (with or without the help of your other arm).

    -Fill your prescriptions given at your preoperative visit in order to have the pain medicine available when you go home from the hospital. One prescription will be a narcotic pain medicine; one is a non-narcotic anti-inflammatory pain medicine; the other is a prophylactic antibiotic to take for the 2 days following surgery.

    -Typically, expect to be out of work for about 7 - 14 days while recovering from the surgery before returning to work with very limited use of your operative arm.

During Surgery:

    -The goal of surgery is pain relief. Rotator cuff surgery in general is “successful” in around 85-90% of cases. Factors such as tear size, tear age, associated problems in the shoulder, and other medical problems may have some effect on the results with your shoulder.

    -The repair may be performed in one of three ways depending on the characteristics of your rotator cuff tear:

    *arthroscopically through several small incisions (<1 cm each)

    *through a small open incision (about 3 cm) on the side of the shoulder

    *through a regular open incision (about 6 cm) on the front of the shoulder

    Each of the techniques requires the same postoperative protocol after surgery to protect the repair from tearing again as well as preventing stiffness.

After Surgery:

    -Remember to ice your shoulder for several days after surgery to help control the

    postoperative pain. Move your wrist and fingers often to prevent stiffness and swelling.

    - You may remove the dressings 4 days after surgery; replace them with band-aids and shower over the wounds at that time. I will see you in the office between 7 to 14 days after surgery to remove the skin stitches.

Postoperative Therapy:

    -Complying with the postoperative protocol is critical to your recovery from rotator cuff surgery! Too aggressive therapy may lead to a recurrent tear while a lack of therapy can lead to irreversible stiffness in the shoulder. The exercises are simple, but several sessions per day (on your own at home) are required to maximize your result.

    -Use your medicine to control the pain such that you can start your postoperative exercises within a few days after surgery.

    -Passive shoulder motion is utilized for the first 6 weeks. This means you move your operative shoulder by lifting it with the other hand, by leaning over and letting it swing like a pendulum, or by someone else moving it for you. Try not to use the muscles in your operative shoulder at all.

-General guidelines for shoulder motion after surgery:

    - Have your arm straight in front of you by your first visit (10-14 days)

    - Have full motion over your head by about 6 weeks after surgery.

    -You should wear your sling at all times for the first 6 weeks after surgery except for during your shoulder exercises. Ideally, you will not pull on your shoulder muscles at thall until the 6 week mark.

    -I will plan on seeing you once about 10 to 14 days after surgery to remove the stitches and again 6 weeks after surgery to initiate “active motion” of your shoulder. We will thget rid of the sling at the 6 week visit. Obviously, call for an earlier appointment if you have any problems or questions during this time period.

    *”active motion” means you can lift your arm up as high as you want, but do

    not lift any objects weighing more than 3 pounds*

    -You will not start strengthening your shoulder with weights or rubber bands until 12 weeks (3 months) after your surgery.

    -Full recovery will take at least 4 6 months. In some cases with larger or massive tears, full strength recovery may take over 1 year.

Additional websites for general shoulder / rotator cuff information:

American Academy of Orthopaedic Surgeons website:

    http://orthoinfo.aaos.org/

    -click on “Shoulders”, then “Rotator Cuff Tears”

NIH website for shoulder topics:

    http://www.niams.nih.gov/hi/topics/shoulderprobs/shoulderqa.htm

These are referenced off of our website at www.drdougmurray.com or

    www.pocatlanta.com

     *look for Dr. D. Murray under the physician list

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