Rotator Cuff Surgical Repair

From an interview with
Dr. Jeremy McCallum
McLeod Orthopaedics Seacoast

Your shoulder’s rotator cuff plays a key role in keeping the shoulder steady, enabling you to reach things above your head.  McLeod Orthopedic Specialist Dr. Jeremy McCallum explains what can be done to repair a damaged rotator cuff.

Here are highlights from Dr. McCallum’s remarks:
The rotator cuff is four muscles and tendons that surround the shoulder and provide compression, stability and strength, enabling  you to lift your hand overhead. The vascular supply to the tendons is relatively tenuous and can become compromised. Over time, even continuing series of microtear injuries can result in a major problem.  Over time,  even with no injury or with a small injury, a large tear can develop within the tendon of the rotator cuff.
When the rotator cuff is bruised but intact, the rotator cuff can be impinged or squished between the ball of the shoulder socket and the bone above it, the acromion. Occasionally, the acromion will have a small spike or spur on it, making the impingement worse.
An actual tear in the rotator cuff can be very painful and debilitating. The shoulder is less stable and, when you try to lift your arm overhead, the ball slides around as the large muscle on the outside tries to overhead lift. There’s no force coupling or compression of that ball against the socket. This can lead to significant pain, disability, weakness and even stiffness.
If you’re having a rotator cuff repair, the surgery is the easy part. Recovery is the hard part. The surgery essentially is an outpatient procedure. You come into the hospital in the morning, go to sleep and an hour later, you wake up and you go home. It’s about a half day process.
Oftentimes, you’ll be offered a nerve block to provide some pain relief for the first 24 to 36 hours after surgery. But as that block wears off, the pain increases in the shoulder. The pain’s worsened by the fact that you have to stay in a sling. We’re able to kind of replant the tendon into the bone, but the sutures and the anchors that we use are only really strong enough to hold the tendon in place if there’s no heavy lifting or movement of the shoulder. If you start moving the shoulder too much and firing those muscles before that tendon has the chance to actually heal, you’ll simply tear that back off.

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