Repair of Rotator Cuff Tears: Surgery for shoulders with torn rotator cuff tendons can lessen shoulder pain and improve function without acromioplasty.

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Tuesday, August 19, 2008

Preparing for surgery

What type of preparation needs to take place before rotator cuff surgery for rotator cuff tears?

Rotator cuff surgery is considered for healthy and motivated individuals in whom rotator cuff tears interferes with shoulder function.

Successful rotator cuff surgery depends on a partnership between the patient and the experienced shoulder surgeon. The patient's motivation and dedication are important elements of the partnership.

Patients should optimize their health so that they will be in the best possible condition for this procedure. Smoking should be stopped a month before surgery and not resumed for at least three months afterwards--ideally, never. This is because smoking interferes with the healing of the rotator cuff repair and the strength of the cuff tendon. Any heart, lung, kidney, bladder, tooth, or gum problems should be managed before surgery. Any infection may be a reason to delay the operation.

The patient's shoulder surgeon needs to be aware of all health issues, including allergies and non-prescription and prescription medications being taken. Some of these may need to be modified or stopped. For instance, aspirin and anti-inflammatory medication may affect the way the blood clots.

What about the timing of surgery for rotator cuff tear? How long can it be safely delayed? How long will recovery take?

Surgery for chronic cuff tears can be delayed until the time that is best for the patient's overall well-being. Acute rotator cuff tears (those that occur suddenly) have the best chance of being strongly repaired if the surgery is carried out within a month of the tear.

After rotator cuff repair, the patient needs to plan on being less functional than usual for twelve or more weeks after the procedure. The shoulder should not be used with the elbow away from the side for 3 months after a rotator cuff repair. Lifting, pushing, pulling, and many activities of daily living place stresses on the rotator cuff and can place excessive tension on the cuff repair, risking failure of the repair. Driving, shopping, and performing usual work or chores may be difficult during this time. Plans for necessary assistance need to be made before surgery. For people who live alone or those without readily available help, arrangements for home help should be made well in advance.

The shoulder surgeon should answer any questions about the surgery or the recovery period.

How can the costs of rotator cuff surgery for rotator cuff tears be anticipated?

The surgeon's office should be able to provide a reasonable estimate of:

1. the surgeon's fee, and
   
2. the hospital fee.
   

Who should perform rotator cuff surgery for rotator cuff tears and where?

Rotator cuff surgery is a technically demanding procedure that is ideally performed by an experienced shoulder surgeon in a medical center accustomed to performing these procedures at least several times a month. Patients should inquire as to the number of rotator cuff repairs that the surgeon performs each year and the number of these procedures performed in the medical center each year.

Surgeons specializing in rotator cuff surgery may be found through university schools of medicine, county medical societies, state orthopaedic societies, or professional groups such as the American Shoulder and Elbow Surgeons.

Rotator cuff surgery is often performed in a major medical center that performs these procedures on a regular basis. These centers have surgical teams and facilities specially designed for this type of surgery. They also have nurses and therapists who are accustomed to assisting patients in their recovery from rotator cuff surgery.

Repair of Rotator Cuff Tears

Surgery for rotator cuff tears at the University of Washington

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