Mexico, MO Rotator Cuff Tears: Surgical Treatment Options
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). A partial tear, however, may require only a trimming or smoothing procedure called a debridement. A complete tear is fixed by stitching the tendon back to its initial site on the humerus.
The rotator cuff tendons cover the head of the humerus (upper arm bone), really helping you to raise and rotate your upper arm. That is the reason that a torn rotator cuff in Mexico, MO is a big deal. Do not take chances with this kind of thing. If you have a torn rotator cuff, go to a doctor who has many years of experience working with patients with this very problem. For those in Central Missouri, Dr. Kathleen Weaver of Audrain Orthopaedics is a great source to go to.
Whenever Rotator Cuff Surgery is Suggested
Your doctor might offer surgery as an option for a torn rotator cuff if your pain does not greatly improve with nonsurgical methods. Continued pain is the main indication for surgical treatment. If you are really active and employ your arms for overhead work or sports, your doctor might also suggest surgical treatment. Other signs that surgery might be a good option for you consist of:
- Your symptoms have lasted 6 to 12 months
- You have a sizeable tear (greater than 3 cm) and the quality of the encompassing tendon tissue is good
- You have significant weakness and decrease of function in your shoulder
- Your tear was brought on by a recent, acute injury
Surgical Repair Options
There are a handful of choices for mending rotator cuff tears. Advancements in surgical techniques for rotator cuff repair include less invasive treatments. Even though each of the methods available has its own advantages and disadvantages, all have the very same goal: getting the tendon to heal.
The type of repair work performed depends on a number of factors, including your surgeon's experience and familiarity with a certain procedure, the size of your tear, your anatomy, and the quality of the tendon tissue and bone.
Many surgical repair work can be done on an outpatient basis and do not require you to stay overnight in the hospital. Your orthopaedic surgeon will discuss with you the very best procedure to satisfy your individual health needs.
You may have some other shoulder issues in addition to a rotator cuff tear, like biceps tendon tears, osteoarthritis, bone spurs, or other soft tissue tears. During the procedure, your surgeon may have the opportunity to take care of these issues, also.
The three techniques more commonly used for rotator cuff repair include standard open repair, arthroscopic repair, and mini-open repair. In the end, patients rate all three repair approaches the same for pain relief, strength improvement, and overall satisfaction.
A standard open surgical laceration (several centimeters long) is often needed if the tear is large or complicated. The surgeon makes the cut over the shoulder and detaches one of the shoulder muscles (deltoid) to better see and gain access to the torn tendon.
In the course of an open repair, the doctor generally removes bone spurs from the underside of the acromion (this procedure is called an acromioplasty). An open repair may be a good option if the tear is big or complex or if added reconstruction, such as a tendon transfer, is indicated.
Open repair was the first technique utilized for torn rotator cuffs. Over the years, new technology and improved surgeon experience has led to less intrusive procedures.
During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your shoulder joint. The camera shows images on a television display, and your doctor uses these pictures to guide little surgical instruments.
Throughout arthroscopy, your surgeon can see the structures of your shoulder in great detail on a video monitor.
Because the arthroscope and surgical tools are thin, your surgeon can use very small incisions (cuts), instead of the bigger incision required for standard, open surgical operation.
All-arthroscopic repair is typically an outpatient procedure and is the very least invasive method to fix a torn rotator cuff.
The mini-open repair makes use of latest technology and instruments to perform a repair by means of a tiny incision. The incision is generally 3 to 5 cm long.
This technique uses arthroscopy to evaluate and deal with damage to other structures within the joint. Bone spurs, for instance, are commonly eliminated arthroscopically. This avoids the need to detach the deltoid muscle.
When the arthroscopic portion of the procedure is carried out, the surgeon repairs the rotator cuff through the mini-open incision. During the tendon repair, the surgeon checks out the shoulder structures directly, instead of via the video monitor.
Following surgery, you will feel pain. This is a natural part of the healing process. Your physician and nurses will work to decrease your pain, which can help you recoup from surgery faster.
Medications are typically prescribed for short-term pain relief after surgery. Many types of medicines are readily available to help regulate discomfort, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor might utilize a combination of these medicines to boost pain relief, and also minimize the need for opioids.
Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. Opioid dependency and overdose has become a critical public health issue. It is very important to use opioids only as directed by your doctor. When your pain begins to improve, stop taking opioids. Speak to your doctor if your pain has not started to improve within a few weeks following your surgery.
Rehabilitation plays a vital role in getting you back to your daily activities. A physical therapy program will help you regain shoulder strength and motion. When you find yourself seeking that physical therapy help in Mexico, MO, go to Dr. Kathleen Weaver for the help you require.
Immobilization. Immediately after surgery, therapy progresses in stages. At first, the repair has to be safeguarded while the tendon heals. To keep your arm from moving, you will most likely use a sling and avoid using your arm for the first 4 to 6 full weeks. The length of time you require a sling depends upon the severity of your injury. Active exercise throughout rehabilitation might include isometic external rotation exercises.
Passive exercise. Even though your tear has been repaired, the muscles all around your arm continue to be weak. When your surgeon decides it is safe for you to shift your arm and shoulder, a therapist is going to help you with passive exercises to enhance range of motion within your shoulder. With passive exercise, your therapist supports your arm and moves it in different positions. In most cases, passive exercise is begun within the very first 4 to 6 weeks after surgery.
Active exercise. After 4 to 6 weeks, you are going to progress to doing active exercises without the help of your therapist. Moving your muscles by yourself will slowly increase your strength and boost your arm control. At 8 to 12 weeks, your therapist will start you on a strengthening exercise program.
Count on a complete recovery to take several months. Most patients have a functional range of motion and adequate strength by 4 to 6 months following surgery. Though it is a slow process, your dedication to rehabilitation is vital to a successful outcome.
Many patients report improved shoulder strength and less pain after surgery for a torn rotator cuff.
Each surgical repair technique (open, mini-open, and arthroscopic) has comparable results in terms of pain relief, improvement in strength and function, and patient satisfaction. Surgeon expertise is more important in attaining satisfactory results than the choice of technique.
Factors that can reduce the probability of a satisfactory result include:
- Poor tendon/tissue quality
- Large or massive tears
- Unsatisfactory patient compliance with rehabilitation and limitations after surgery
- Patient age (older than 65 years)
- Smoking and use of other nicotine products
- Workers' compensation claims
Shortly after rotator cuff surgery, a modest percentage of patients experience complications. Along with the risks of surgery as a whole, such as blood loss or complications connected to anesthesia, complications of rotator cuff surgery may include:
- Nerve injury. This generally involves the nerve that activates your shoulder muscle (deltoid).
- Infection. Patients are given antibiotics in the course of the procedure to lower the risk for infection. If an infection develops, an extra surgery or prolonged antibiotic treatment might be needed.
- Deltoid detachment. During an open repair, this shoulder muscle is detached to offer better access to the rotator cuff. It is stitched back into area at the end of the treatment. It is extremely important to protect this area after surgery and during the course of rehabilitation to allow it to heal.
- Stiffness. Early rehabilitation lessens the likelihood of permanent stiffness or loss of motion. The majority of the time, stiffness will improve with more aggressive therapy and exercise.
- Tendon re-tear. There is a chance for re-tear following all types of repairs. The bigger the tear, the higher the risk of re-tear. Patients who re-tear their tendons generally do not have greater pain or decreased shoulder function. Repeat surgery is required merely if there is severe pain or loss of function.
As you can see, there are a lot of steps in the process of recuperation from your rotator cuff trauma. If you do not stick to a very carefully-plotted regime, you take the chance of furthering the duration or extent of your injury. Be sure to seek counsel from a qualified orthopedic doctor such as Dr. Kathleen Weaver to ensure that you have the assistance you need. Audrain Orthopaedics is here to assist you with all your orthopedic health needs within Audrain County.