Rotator Cuff Injury/Repair for Shoulder Pain

A tear in any portion of the rotator cuff is called a rotator cuff tear. Most commonly tear is present in the supraspinatus tendon.

There are several classifications for the tear of the rotator cuff.

The tear can be

• Partial tear- this usually involves a tear of the tendon, which is incomplete, but continuity is maintained. It can be divided into
• a) Articular- towards the humeral/ arm bone or shoulder joint side.
• b) Bursal- towards the acromion side or above the shoulder joint.
• Complete tear- this involves full-thickness tear of the joint. There is no continuity of the tendon.

The tear can be

• Degenerative- which occurs in older adults due to repetitive trauma to the tendon
• Traumatic- occurs in young adults due to trauma

The tear can also be differentiated based on size and location.

• Pain
• Swelling
• Painful movement at the shoulder joint
• Unable to move arm above head, ex. Combing hair, using towels, playing sports, lifting boxes in the kitchen
• Pain during the night while sleeping on the shoulder, which is affected
• In severe cases, weakness of the shoulder will be present

Rotator cuff tears are seen in X-rays and MRIs.

Most cases of rotator cuff injury are usually treated with

• Rest
• Hot/ cold compression
• Pain killers
• Physical therapy

In a few cases, surgery is required

Yes, in most cases, rotator cuff injury can be treated without surgery. But in cases where after a long duration of non-surgical management, improvement is not their surgery is considered.

In a few cases, injections are also given in the shoulder joint

• Hyaluronic acid
• Steroids
• Platelet-rich plasma
• Stem cells

Biologicals like platelet-rich plasma growth factors and stem cells help decrease pain and increase shoulder joint movement. Injections in shoulder joints are routinely used throughout the world clinically. They also help in reducing pain and increase movement. But further studies are required to prove the efficacy of these shoulder injections

The pain in the shoulder will increase, and movement at the shoulder will decrease with time.

It will be difficult for patients to do their daily activities.

We always believe in “why add numbers to your age and add quality years to life”.

No rotator cuff tears don’t heal on their own, but with time, they increase, and the patient's condition will worsen.

Yes, many studies have shown that the size of the tear may increase, and it can become a full tear from a partial one.

This depends on many factors

• Age of patient
• Activity level of patient
• Type, size, location, partial or full tear
• If, after taking treatment for a long duration, the patient still has pain and problems with the movement of the shoulder.
• Pain during the night, which doesn’t let the patient relax
• Patient wants to return to sports activities

Consult your surgeon about proper treatment, as it depends on many factors.

It depends on

• Type, size, location, partial or full thickness tear
• Presence of other conditions like acromion end shape, inflammation of bursa/ sac

Surgery for rotator cuff surgery is double-row rotator cuff repair. It is the gold standard surgery for rotator cuff tears. Double-row rotator cuff repair involves knotless suture anchors; the tendon is fixed to the bone in a double row to provide extra strength for fixation. The use of fibre tape provides extra strength to repair compared to fibre wire. In comparison to single-row repair, which was used earlier, double-row rotator cuff repair helps in faster recovery, fewer chances of failure and quick return to day-to-day activities.

This totally depends on the surgeons’ preference, the surgery cost and the implants' availability. We use a knotless suture anchor, one of the latest and most advanced suture anchors. 

Usually, it depends on the patient's medical condition; if the patient is not suffering from any disease before surgery, hospital stay is for 1-2 days. 

After double-row rotator cuff repair surgery, you can shower within 4-5 days. Usually, waterproof dressing is applied to the wound, after which the patient can shower. But to take a bath or swim a patient will require 4-6 weeks. The patient has to keep the wound dry and avoid using hot water as it increases swelling.

You can usually drive after double-row rotator cuff surgery after 4- 6 weeks. But it has to be consulted with a surgeon and a physiotherapist.

A patient must use a sling after double-row rotator cuff repair for 4-6 weeks. After which the patient will have to follow a regular physiotherapy routine for several weeks. Patients can start low-impact activities after 4-6 weeks, like driving a car and doing routine activities. Complete recovery of patients will take 3- 4 months.

Usually, if a patient’s office work involves a desk job and no heavy work activities, he can join the office in 3- 6 weeks. In case it’s a field job and requires heavy work activities, it may take 3-4 months.

Usually, if only double-row rotator cuff repair is done, the patient will require physiotherapy for 3-6 months, which can be done by the patient himself after a few weeks.

It depends on the recovery course of the patient after double-row rotator cuff repair surgery, but usually, patients can get back to sports in 4-6 months. Initially, some surgeons started to decrease recovery duration to 3-4 months, but it was observed in various studies that chances of failure have increased. We follow the international standards of proper rehabilitation and advice our patients to return to sports after 4-6 months after proper physical training. We believe we should follow the latest, best and thoroughly studied techniques and provide results comparable to international standards.

After arthroscopic double-row rotator cuff repair, complications and rates have decreased to a larger extent but still can occur. This includes infection, nerve injury, stiffness of the shoulder, implant failure, and rotator cuff re-tear.

It depends on the hospital category chosen by patients and the type of implant discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included arthroscopic double-row rotator cuff repair surgery.