Arthroscopic Rotator Cuff Repair
Arthroscopic rotator cuff repair is done in cases lending themselves well to the precise instruments and technique of the arthroscopic procedure - which is generally a tear with no other associated injury. In such procedures preoperative planning is key. The procedure is outlined carefully, a health assessment is performed and rehabilitation expectations are discussed before the procedure is scheduled.
Patients then meet with the anesthesiologist to review their health history and discuss the type of anesthesia to be used during the procedure.
Placed either lying on their side or in a comfortable sitting position, the procedure is performed under a general anesthesia. Small incisions, or portals, are made in the back, side and front of the shoulder. Initially a complete diagnostic arthroscopy is performed. The arthroscope is inserted and a complete inspection of the bursa, as well as the biceps tendon, labrum and surrounding ligaments, tendons and cartilage surfaces are carefully inspected. When it is determined that no other injury exists, the repair and/or decompression of the supraspinatus or rotator cuff tendon of the shoulder is begun.
Upon completion, the area of the incision is not sutured, in order to allow for egress (drainage) of the fluid used in the arthroscopic procedure - minimizing swelling and bruising.
Recovery and Rehabilitation
The recovery and rehabilitation of an arthroscopic procedure is much easier than that which is experienced following traditional surgery with a large incision.
Following a period of rest and stabilization of the arm by keeping the elbow beneath shoulder level, the doctor will determine which series of resistive shoulder strengthening exercises should begin. When patients are advised to proceed, they will be instructed to perform a series of exercises using a latex exercise band in order to provide both positive and negative force for muscle strengthening. The exercises improve range of motion and encourage involvement of surrounding muscle groups.
The emphasis during this phase of recovery is also on strengthening the shoulder in flexion, abduction, internal rotation and external rotation - as well as helping stretch the shoulder into internal rotation and strengthening the scapula rotators.