The shoulder cuff is also called the rotator cuff.
The muscles and tendons of the rotator cuff connect and hold in position the humerus (upper arm bone) to the shoulder blades and the shoulder socket respectively.
The arm bone is held in position by four muscles of the rotator cuff attached by four tendons. Rotator cuff surgery is to repair any tear in either of these tendons.
The doctor records a thorough medical history and performs a physical examination. This is extremely crucial for an accurate diagnosis of rotator cuff injuries.
Physical examination involves a certain series of movements the doctor asks you to perform to determine pain.
The doctor may ask to perform certain tests such as X-rays, ultrasound, or MRI to confirm the diagnosis. Only then will the doctor decide if the surgery will be appropriate.
Additionally, the doctor may further examine the shoulder using an Arthroscope (camera attached to a video monitor).
This is an invasive diagnostic procedure performed by numbing the area from where the arthroscope is inserted.
Using the camera, the doctor observes the tendons, ligaments, cartilage of the rotator cuff and estimates if surgery will be effective in treating the shoulder condition.
A conservative approach of rest and ice packs may help if the tear in the tendon is a minor one.
However, a torn tendon does not self-repair; rest, ice packs, and exercises may lessen the pain, but the cause remains.
The patient experiences weakness in the shoulder that comes in the way of everyday activities.
The pain lasts more than six months despite physical therapy.
The patient is an athlete.
The nature of the work of the patient requires regular usage of arms and shoulders.
Rotator cuff surgery is generally recommended for fresh injuries than chronic conditions. It is advised to visit the doctor as soon as an injury is suspected.
The doctor may advise you to rest and apply cold packs while awaiting the surgery. Besides, may also put the patient on certain exercises that ease the pain.
The patient in medical history must provide complete information about the medications and/or health supplements consumed.
These doctors may discontinue just before the surgery and resume them later.
The patient is anesthetized. It could be general or regional anesthesia. In general anesthesia, the patient will be asleep during the procedure.
In regional anesthesia, the patient will be awake but the region to be operated on will be numb, such that the patient cannot feel anything. This numbness generally wanes away in up to 16 hours.
In an arthroscopic rotator cuff surgery, three to four small incisions are made. Through one incision, the arthroscope (small camera) is inserted.
In the remaining holes, the surgical instruments are inserted. The instruments help attach the damaged tendon to the bone.
Once the tendon is positioned in the right place the surgeon sutures it to attach, usually performed by using small rivets (suture anchors).
These could be metallic or of a material that dissolves over a period. Both do not require subsequent removal.
For a larger tear, an open incision surgery may be needed and arthroscopic surgery may not be able to effectively repair the damage.
Once completed, the doctor sutures the incisions and bandages.
The doctor advises the patient to use a sling for four to six weeks. A shoulder immobilizer too may be needed.
For a few days after the surgery, the doctor may maintain a dose of painkillers to manage the pain effectively.
As the shoulder begins to heal, the doctor starts exercises to restore muscle strength and range of motion of the shoulder.
Complete recovery occurs over a period of three to six months. This is also dependent on the extent of the injury.
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