Rotator cuff repair surgery is a surgical procedure aimed at repairing shoulder tendon injuries, primarily targeting pain and functional impairment caused by rotator cuff tears. The rotator cuff consists of four shoulder tendons; tears resulting from trauma or degeneration can lead to difficulty lifting the arm, nocturnal pain, and other symptoms. The goal of the surgery is to re-suture the torn tendons, restoring their connection to the bone to improve joint stability and mobility.
This procedure is usually indicated for patients who do not respond to conservative treatments, including physical therapy, analgesics, or corticosteroid injections, yet continue to experience pain. The type of surgery is chosen based on the extent of injury and patient condition, often combined with arthroscopic minimally invasive techniques to reduce trauma.
Rotator cuff repair is divided into two main categories: "Open Surgery" and "Arthroscopic Surgery." Open surgery requires a larger incision and is suitable for severe injuries or complex anatomical abnormalities; arthroscopic surgery uses an endoscope, involves smaller incisions, and has a faster recovery, making it the current mainstream choice.
The surgical mechanism involves three steps: first, removal of damaged tissue; second, fixation of the tendon to the bone surface using suture anchors; and third, reinforcement with sutures. Biological repair techniques may incorporate growth factors or stem cell technology, but traditional suturing remains the primary method.
Main indications include the following conditions:
Special cases include:
The surgery is typically performed under general anesthesia or brachial plexus block. Arthroscopic procedures require establishing 2-3 small incisions in the shoulder joint to insert the endoscope and instruments for suturing. Open surgery involves an 8-10 cm incision for direct visualization and operation.
Postoperatively, a sling or shoulder immobilizer is used to fix the shoulder for 4-6 weeks, combined with staged rehabilitation plans. Physical therapy is divided into three phases: the first week focuses on joint mobility, the second week adds gentle resistance training, and full range of motion is gradually restored after three months.
Main therapeutic effects include:
Advantages include:
Potential complications include:
Serious Risks: Deep infections may require secondary debridement; thrombosis risk is about 0.5-1%, necessitating postoperative thromboprophylaxis.
Contraindications include:
Preoperative considerations include:
Interactions with anesthetic drugs require special attention; long-term NSAID use may delay healing, so discontinuation is recommended 7 days before surgery. It is often performed concurrently with other procedures such as acromioplasty under shoulder arthroscopy.
Synergistic effects with physical therapy are important; postoperative rehabilitation should be coordinated with the surgical method, allowing earlier active movement in arthroscopic procedures.
Clinical studies show that about 85% of patients with partial tears experience functional improvement at 1 year post-surgery, while complete tear patients have about 70%. In elderly patients (>65 years), success rates decrease to 60-70%, but pain relief remains above 80%.
Long-term follow-up indicates re-tear rates of approximately 10-15% at 5 years post-surgery, related to tendon fixation strength and patient activity habits. The American Shoulder and Elbow Surgeons scoring system shows an average improvement of 25-30 points.
Non-surgical treatments include:
Surgical alternatives include:
Rehabilitation after rotator cuff repair is generally divided into three stages. The initial phase (0-6 weeks) focuses on joint fixation and avoiding secondary injury; the intermediate phase (6-12 weeks) gradually increases passive joint mobility; the late phase (3-6 months) begins muscle strengthening. The doctor will adjust exercise intensity based on the healing progress of the repaired tissue. Patients must strictly follow the physical therapist’s instructions to avoid exerting force too early, which could cause the repair to rupture.
Is shoulder stiffness or pain common after surgery? How should it be managed?Minor stiffness and discomfort are common during the early healing phase. However, if pain persists beyond two weeks or is accompanied by swelling, it may indicate poor healing or adhesion. It is recommended to return for examination promptly. The doctor may adjust pain management or increase physical therapy frequency. Patients can use ice packs and passive exercises as advised, but should avoid forcibly moving the joint without medical guidance.
When can I resume lifting heavy objects or exercising? What lifestyle restrictions should I observe?Generally, it is recommended to avoid lifting objects over 2 kg with one hand for at least three months after surgery. Activities like swimming and tennis, which involve shoulder rotation, should be avoided for six months. Daily habits should include using both hands for carrying objects and avoiding sudden throwing motions. High-risk occupations (such as manual laborers) should discuss individual work adaptation plans with their physician.
What are the main factors affecting surgical success? What are common reasons for failure?The success rate (about 70-90%) is closely related to the extent of tendon rupture, patient age, and preoperative muscle atrophy. Common reasons for failure include premature loading, inadequate postoperative rehabilitation, chronic diseases like diabetes affecting healing, or original tendon degeneration reaching grade III atrophy. Maintaining blood sugar stability and strictly following the rehabilitation plan are key.
What preparations are needed before surgery? Which health issues may impact surgical safety?Preoperative assessments include joint arthroscopy to evaluate tear extent and cardiopulmonary function tests. Diabetic patients should control HbA1c below 7%. Osteoporosis patients may need calcium and vitamin D supplementation. Discontinuing anticoagulants like aspirin one week before surgery is recommended. Arranging home modifications (such as long-handled grab tools) can facilitate recovery.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
