Arthroscopic Rotator Cuff Repair

Arthroscopy is a minimally invasive surgical technique used in the treatment of sports medicine injuries. It involves the use of a fiber-optic camera, which we place into a joint through a small incision in order to visualize ligaments, cartilage, and soft tissue. Through another small incision, we can then use small instruments to remove or repair broken or damaged tissue.

Shoulder arthroscopy with rotator cuff repair is the term used to describe surgery performed for patients with a torn or damaged rotator cuff. The rotator cuff is comprised of four muscles that allow us to raise our arms up and perform overhead activities. The two rotator cuff muscles located on the top of the shoulder are the ones most commonly torn. In some patients, the space in the shoulder below the clavicle (subacromial space) is narrowed, which causes the rotator cuff to be pinched or impinged on with overhead motion. This can cause chronic tendonitis of the rotator cuff and lead to tearing of the rotator cuff muscles. Rotator cuff tears can also occur as a result of trauma—for example, falling on your shoulder or lifting a heavy object. Regardless of cause, a rotator cuff tear is a significant source of pain. Patients often develop difficulty with reaching overhead, pushing, pulling, or lifting items because of the pain associated with a rotator cuff tear. Arthroscopic rotator cuff repair is often done in conjunction with an arthroscopic subacromial decompression and distal clavicle excision for treatment of shoulder impingement accompanying a rotator cuff tear.

Shoulder arthroscopy with rotator cuff repair involves first, cleaning out the shoulder of any debris or inflamed tissue. During this time, the surgeon will also remove any frayed or damaged tissue of the rotator cuff. Using multiple strong sutures the rotator cuff is secured back to its appropriate position on the ball of the shoulder joint (humeral head).

Post Operative Instructions:

SLING/MOVEMENT

  • For the first 6 weeks after your surgery, you must wear your sling at all times including while you are asleep. You may only remove the sling to shower and to perform range of motion exercises for your elbow.
  • You should flex and extend your elbow 3 to 4 times a day to prevent stiffness. Do not move your elbow away from your body as this may damage the repair.

ICE

  • An ice machine will be provided to you prior to your surgery. This will help decrease swelling and pain after your surgery. Use the ice machine as much as possible when you get home at intervals of 30 minutes on and off. You should keep the ice machine for approximately two weeks. Do not use the ice machine while you are sleeping.

MEDICATIONS

  • An injection of local anesthesia was injected into your shoulder after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
  • The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.
  • A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your shoulder dressing is waterproof. You may shower the next day after surgery. Two days after surgery you may remove the entire dressing. Gently wash the wounds with soap and warm water and towel dry. You may then cover the incisions with band-aids until your post op visit.
  • Do not take a bath or submerge your shoulder in water until your incisions are checked at your first post-op visit.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to two hours. Recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Stitches will be taken out, and you’ll get to see your pictures from the surgery. Continue icing two to three times a day (or more if needed). Continue with the sling for six weeks from date of surgery at all times except when bathing. Physical therapy will be prescribed. Start physical therapy immediately, passive range of motion only (the therapist moves your arm for you).

Six weeks post-op: Second follow-up visit. By this time you should have begun physical therapy. At this point, physical therapy will progress to active and active assisted range of motion exercises (meaning now you can move your arm by yourself). Mild strengthening exercises at physical therapy will continue but with no resistance or lifting greater than 2 lbs. Stiffness and mild discomfort at night and with certain motions is common at this stage of the rehab process.

Ten weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training needed, continue physical therapy to work on rotator cuff strengthening. Pain should be mostly resolved at this point.

Sixteen weeks post-op: Fourth follow-up visit. Range of motion should be full/normal. You should feel stronger and have very little pain, if any. Near to full recovery is expected at this time; some patients will require additional four weeks of physical therapy to continue with rotator cuff strengthening exercises.





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