What Is Rotator Cuff Repair?
The rotator cuff is a group of four muscles and their tendons that surround the ball of the shoulder. They hold the ball in the socket and help you lift and rotate your arm. A tear can happen suddenly, from a fall or lifting something heavy, or develop gradually from wear over time.
Most rotator cuff repairs are done arthroscopically, through a few small incisions with a camera. The surgeon cleans the torn edge, prepares the bone and uses small anchors with sutures to hold the tendon against the bone while it heals. Other problems, such as bone spurs or an irritated biceps tendon, can often be treated during the same operation.
Performed as an outpatient procedure at a hospital or surgery center where our surgeons operate, with evaluation, imaging and physical therapy here in our Boynton Beach office.
Who Is a Candidate?
Surgery may be recommended if you have a full-thickness tear with ongoing pain and weakness, a tear caused by a sudden injury, especially in a younger or active person, or symptoms that have not improved after several months of physical therapy and other non-surgical care. Many partial tears and some wear-related tears do well without surgery.
Our surgeons generally start with non-surgical treatment when it is reasonable: physical therapy, activity changes, medication and injections. Dr. Chalal also uses PRP injections in selected patients. PRP is prepared from your own blood, evidence is still developing, results vary, and insurance usually does not cover it.
What to Expect
Your evaluation includes an exam and imaging in our office, which may include an X-ray, diagnostic ultrasound or MRI to see the size and location of the tear. Surgery is usually outpatient and takes about one to two hours. Many patients receive a nerve block for pain relief along with general anesthesia. You will go home the same day in a sling.
Risks and Side Effects
Risks include infection, stiffness, nerve injury, blood clots, problems from anesthesia or the nerve block, and failure of the tendon to heal, sometimes called a re-tear. Larger tears, older tears and smoking are linked with a higher chance of the tendon not healing. Following your sling and therapy instructions protects the repair.
Recovery
Rotator cuff recovery is gradual. You will usually wear a sling for about four to six weeks. Gentle motion, often guided by a therapist, starts early. Strengthening typically begins around three months. Most people regain much of their function by six months, and improvement can continue for up to a year. Timelines vary with the size of the tear and your health.
Our physical therapists work in the same office and share your chart with your surgeon, so each phase of therapy matches how your repair is healing.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
Rotator cuff repair is usually covered by Medicare and most commercial PPO plans when it is medically necessary, often with prior authorization. HMO and managed-care plans need your primary care physician's referral before the visit. Co-pays, co-insurance and deductibles apply. PRP is usually not covered. For injuries at work, we accept workers' compensation and coordinate treatment, documentation and return-to-work planning. Call our office to verify your benefits.
When to Talk to a Specialist
Schedule a visit if shoulder pain keeps you up at night, you have trouble lifting your arm, or you notice weakness after a fall or lift. Go to the emergency room or call 911 if the shoulder looks deformed after an injury, or after surgery you have fever, spreading redness or drainage from an incision.
