Rotator Cuff Repair Surgery - Diagnosis & Procedure

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What is Rotator Cuff Repair?

Rotator cuff injury surgery is a specialised medical procedure designed to repair torn tendons in the shoulder. These tendons are integral to arm mobility and stability. When they tear, they can cause severe discomfort and limit your ability to move your arm freely.

Performed by seasoned orthopaedic surgeons, rotator cuff repair surgery is typically conducted on an outpatient basis, so you don’t have to worry about extended stays at the hospital. It’s an incredibly common and safe procedure that has helped countless individuals regain their full range of motion.

During the procedure, surgical tools, including sutures and bone anchors, are used to reattach the torn tendon to the humerus, which is your upper arm bone. If the tear is only partial, debridement may be carried out to trim and smooth the tendon rather than executing a full repair.

What Are The Types Of Rotator Cuff Repair Surgery?

Rotator cuff repair surgery has seen many advances over the years, with several types of procedures available based on the severity and location of the tear. Here are the main types of rotator cuff injury surgeries:

  • Open Repair: This traditional form of surgery involves making a several-centimetre incision over the shoulder area. The deltoid muscle is detached or split open to access and repair the torn tendon. Bone spurs, if present, are removed from the underside of the acromion. This approach is typically used for larger, more complex tears or when additional reconstruction is needed.
  • Arthroscopic Repair: This is a minimally invasive procedure that utilises small incisions and an arthroscope. This camera device helps to view and repair the tear, with miniature surgical instruments inserted through the incisions to reattach the tendon. As the least invasive option, it is often performed as outpatient surgery.
  • Mini-Open Repair: This combines elements of both open and arthroscopic repair. First, arthroscopy is used to evaluate and treat any other shoulder issues, like bone spurs. Then a 2-3 inch incision is made to repair the rotator cuff tendon. This method causes less soft tissue damage than a full open repair, leading to quicker recovery times.

Remember, your doctor will choose the most suitable procedure based on your individual condition and needs.

Diagnosis Before Rotator Cuff Repair Surgery

Diagnosing a rotator cuff injury that requires surgical intervention involves a series of steps. These include:

  • Medical History: A comprehensive review of your medical history plays a vital role in diagnosing rotator cuff tears. Your doctor will ask about any past injuries, the duration and nature of your symptoms, and activities that may aggravate your shoulder pain.
  • Physical Examination: Your physician will perform a series of shoulder movement tests to assess the location and severity of the injury. They may test your range of motion, strength, and stability to determine the extent of the tear.
  • Imaging Tests: In certain cases, X-rays, MRI scans or ultrasound may be ordered to verify the diagnosis and evaluate the extent of the tear. These imaging tests provide detailed pictures of structures within your shoulder, helping the doctor confirm a rotator cuff tear.

What Is The Procedure For Rotator Cuff Repair Surgery?

Rotator cuff repair surgery aims to fix torn tendons in the shoulder. The procedure entails:

  • Anaesthesia: The surgery is usually performed under general anaesthesia so you won’t feel any pain during the operation.
  • Incision: Depending on the nature of your injury, your surgeon will choose one of three approaches: open repair (a large incision), mini-open repair (initial arthroscopy followed by a smaller incision), or arthroscopic repair (small incisions and a camera).
  • Repair: Once access is granted to the torn tendon, it is repaired using sutures and anchors to reattach it to the humerus, which is the upper arm bone. If necessary, bone spurs will be removed.
  • Closure: The incisions are then stitched up, and a bandage applied to protect the surgical site as it heals.

Who Is The Right Candidate For Rotator Cuff Repair Surgery?

Determining if you’re a suitable candidate for rotator cuff repair surgery depends on several factors. These include:

  • Severity of Symptoms: If you experience consistent pain, persistent weakness or limited range of motion that impairs your day-to-day activities, surgery may be a viable option.
  • Failure of Conservative Treatment: Surgery is considered when non-surgical treatments such as physical therapy, rest, and medication do not relieve rotator cuff injury symptoms.
  • Size of the Tear: Large or complex tears, or those that affect most of the tendon, are likelier candidates for surgical repair.
  • Patient’s Age and Health: Younger, active individuals in good overall health are more likely to benefit from rotator cuff repair surgery. However, each case is unique and the surgeon will make a decision based on your specific circumstances.

What Are The Benefits Of Rotator Cuff Repair Surgery?

If you’re experiencing persistent shoulder pain and weakness, rotator cuff repair surgery might be a solution for you. Here’s how it could help:

  • Significant Improvement in Shoulder Strength: One of the key benefits of undergoing this surgery is that it considerably improves shoulder strength, helping you to undertake daily tasks with greater ease.
  • Pain Relief: Another major advantage is that majority of patients report a significant reduction in pain post-surgery.
  • Similar Results Across Techniques: Whether you opt for open surgery, mini-open or arthroscopic techniques, patient satisfaction, pain relief and strength improvement remain similar across all methods.
  • Faster Recovery with Arthroscopic Repair: Compared to open repair, arthroscopic repair offers benefits such as less tissue damage, faster recovery, less discomfort and smaller scars.

How To Prepare For Rotator Cuff Repair Surgery?

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What Are The Recovery Tips And Precautions To Follow After Rotator Cuff Repair Surgery?

Post-surgery recovery needs careful handling. Here’s what you can do to ensure smooth healing:

  • Wear a Sling: To protect the repaired tendon, it is advisable to immobilise your arm with a sling for about 4-6 weeks.
  • Limit Arm Use: Avoid using your arm for activities aside from those illustrated by your physical therapist for the first 4-6 weeks.
  • Exercise Gradually: Gentle range-of-motion exercises can be started in the first 4-6 weeks. You can then progress to strengthening exercises over time.
  • Patience is Key: It may take 4-6 months to regain functional range-of-motion, and even longer for complete recovery.
  • Avoid Smoking: Smoking and nicotine use can hinder your chances of a satisfactory result.

Potential Risks Or Complications Associated With Rotator Cuff Repair Surgery

Like any surgical procedure, rotator cuff repair surgery carries some risks, including:

  • Nerve Injury: This commonly involves the nerve of the deltoid muscle.
  • Infection: If an infection occurs, it might require additional surgery and antibiotics.
  • Deltoid Detachment: This can occur during open repair. Be mindful to protect it during rehab.
  • Stiffness: While this usually improves with more aggressive therapy, it may be uncomfortable initially.
  • Tendon Re-tear: Although this is more likely with larger tears, it usually does not necessitate repeat surgery if pain and function are acceptable.

Remember, your full participation in the rehabilitation programme and diligently following your surgeon’s instructions are key to a successful recovery.

What Is The Cost Of Rotator Cuff Repair Surgery In India?

  • Rotator cuff repair surgery is a procedure performed to mend a torn tendon in the shoulder. The cost in India can significantly var. This variation in cost can be affected by several factors including:

    • Type of Surgery: Whether the surgery is open, arthroscopy, or mini-open can determine the cost.
    • Severity of Tear: The complexity and severity of the tear in your rotator cuff will also influence the cost of rotator cuff injury surgery.
    • Surgeon and Hospital Fees: Fees can range based on the expertise of your surgeon and the hospital you choose for your treatment.
    • Geographic Location: The cost of medical procedures can differ across various cities or regions within India.
    • Public or Private Hospital: Private hospitals generally have higher costs compared to public hospitals.
    • Insurance Coverage: Depending on your policy, insurance may cover part of the cost of your procedure.

Is Rotator Cuff Repair Surgery Covered Under Insurance?

The coverage for rotator cuff repair surgery largely depends on your individual insurance policy. In general, insurance companies do provide coverage for such surgeries. This typically includes the surgeon’s fees, assistant surgeon’s fees, anaesthesiologist fees, and hospital costs. However, there might be exclusions such as premium ward rooms or experimental procedures. If you have a pre-existing condition that complicates the operation, treatment for it may not be included.

In India, insurance coverage differs by provider. It is crucial to consult with your insurance provider about the specific details of your plan before scheduling a surgery. This will give you a clear understanding of what costs you can expect to cover out-of-pocket.

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