The rotator cuff muscle is a prime muscle in stabilizing the shoulder joint and allows us to lift the arm above the head. Due to wear and tear over time, it is common in patients above the age of 50 years to develop a rotator cuff tear. Often, this tear occurs without any fall or trauma. However, sometimes due to prevailing degeneration within the rotator cuff, a trivial trauma – such as a fall in the bathroom or at times even after a throwing injury. Patients complain of pain at the side of the arm and inability to actively lift the arm.
The rotator cuff tear can be diagnosed either by ultrasound or MRI examination. If there is a partial tear, this can be treated by our PSRP (Partial Supraspinatus Rotator cuff Program) shoulder rehab program. But once a full thickness tear occurs, it can only be treated by surgical repair. Without repairing the tear, the shoulder cannot regain function. Local heat or physiotherapy does not address the cuff defect. The tear will propagate with time and the later a patient presents, the poorer the outcome. Some patients have to be refused surgery as they present too late.
Traditionally, the rotator cuff used to be repaired with open surgery leading to adhesions and post-operative stiffness, and recovery generally takes a very long time. At our clinic, the rotator cuff is repaired arthroscopically with the use of imported suture anchors. After arthroscopic repair, patients go home the next day of surgery with hardly any scar. Also, working patients tend to join back work within a week of surgery. So far, we have hardly had complications with arthroscopic repair. In our series, the chance of re-tear especially with patients presenting within a few months of tear is less than 1%. Patients presenting late will tend to have a poor quality of muscle to repair.
You should come for surgery with a prior fixed appointment. If any tests are due then they will be performed. In case you have forgotten any investigation, it is best to draw the attention of the Hospital Doctor who has seen you. Certainly, avoid smoking for a week before surgery and six weeks after surgery. Nicotine has an adverse effect on general anesthesia. Smoking also retards healing of tissue and re-tear rates are higher in smokers. Avoid alcoholic drinks a day before and after surgery as alcohol counteracts with your medication. It is desirable to have a bath before surgery.
