rotator cuff disorders are treated without surgery.
But surgery may be considered if the injury is very severe. Surgery also may be
recommended if the shoulder does not respond well after 3 to 6 months of
nonsurgical treatment (rest, ice or heat, use of
nonsteroidal anti-inflammatory drugs, and
Surgery for rotator cuff disorders is done to:
- Repair tendon tears and smooth the underside of
the upper point of the shoulder blade (acromion) to make more room for the
tendon and bursa.
- Restore strength and use of the shoulder.
Surgery may be a good first choice for shoulder weakness
caused by complete tears, especially when the rotator cuff is otherwise healthy
(little or no degeneration). Surgery may be considered if you have severe pain
and loss of shoulder function that has not responded to appropriate nonsurgical
treatment.1 This lack of improvement may indicate that
you have partial rotator cuff tears, complete tears, or subacromial roughness.
Surgery for these problems focuses on creating a smooth passage for the tendon
and bursa beneath the acromion.
You may regain more of your
shoulder strength and movement after an acute tear if it is repaired soon after
the injury. If surgery is delayed, repair of a large tear may not be as
successful, but damaged tissues can still be removed and pressure on the tendon
and bursa reduced. This usually relieves pain and restores enough strength for
you to do routine, nonstrenuous activities.
surgery (home treatment and physical therapy) is important to the success of
surgery. People who are not willing or able to commit themselves to the rigors
of physical rehab may not do as well after surgery.
Shoulder surgery for rotator cuff disorders usually
involves one or more of the following procedures:
- Subacromial smoothing
- Rotator cuff repair
These procedures may be done
arthroscopically, by traditional open surgery, or by a
combination of the two approaches.
What To Think About
Both arthroscopic surgery and
open surgery can be effective. Your surgeon may be more comfortable with one of
- Open surgery is the traditional type of
surgery for rotator cuff disorders.
debridement and smoothing to repair the rotator cuff
is becoming more common.
- A combination of open surgery and
arthroscopy may allow your doctor to split rather than cut the shoulder muscle
(deltoid) during open surgery, so you may have a less difficult recovery.
The success of surgery for rotator cuff tears depends on
many things, such as:
- The amount of degeneration
- Your age.
- Other medical conditions. Some
medical conditions may cause you to heal slower.
- Your recovery
goals and commitment to and compliance with a physical rehabilitation
- Whether you smoke, because smoking decreases the blood
supply throughout the body and slows the healing process.
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