Our Summary

This research reviews existing studies on arthroscopic repair, a type of minimally invasive surgery, for severe long-term rotator cuff tears (a common shoulder injury). The researchers looked at studies that specifically focus on significant tears, dismissing those that did not clearly define “massive” or included patients with less severe injuries.

In total, they analyzed 18 studies involving 954 patients, whose average age was 63. The majority of the patients (81%) underwent complete repair surgeries while 19% had partial repairs. The surgeries were generally successful in improving pain levels, range of movement, and overall shoulder function. However, they found a high rate of patients experiencing a re-tear, at 79%.

The researchers noted that the overall quality of the existing research was poor. They concluded that while arthroscopic repair can improve symptoms and function for severe rotator cuff tears, the high rate of re-tearing is concerning. They also emphasized the need for better quality research in this area.

FAQs

  1. What is arthroscopic repair and how is it used for severe rotator cuff tears?
  2. What were the main findings of the research on arthroscopic repair for severe rotator cuff tears?
  3. How did the researchers address the high re-tear rate in patients who had undergone arthroscopic repair for severe rotator cuff tears?

Doctor’s Tip

A doctor may advise a patient undergoing rotator cuff repair surgery to follow a strict rehabilitation program to ensure proper healing and prevent re-tearing of the repaired tissue. This may include physical therapy exercises to strengthen the muscles around the shoulder, as well as avoiding certain activities that could put strain on the shoulder. It is important for patients to follow their doctor’s post-operative instructions closely to maximize the success of the surgery and reduce the risk of complications.

Suitable For

Patients typically recommended for rotator cuff repair are those with severe, long-term rotator cuff tears that have not responded to conservative treatments such as physical therapy or corticosteroid injections. These patients may experience significant pain, limited range of motion, and difficulty performing daily activities. The decision to undergo surgery is typically made after a thorough evaluation by a healthcare provider, taking into account the patient’s overall health, activity level, and goals for treatment.

Timeline

Before rotator cuff repair:

  1. Patient experiences shoulder pain, weakness, and limited range of motion.
  2. Patient may undergo imaging tests such as MRI to diagnose the severity of the tear.
  3. Patient may undergo conservative treatments such as physical therapy, corticosteroid injections, and rest.

After rotator cuff repair:

  1. Patient undergoes arthroscopic rotator cuff repair surgery.
  2. Patient goes through a rehabilitation program to regain strength and range of motion in the shoulder.
  3. Patient may experience improvements in pain levels, range of motion, and overall shoulder function.
  4. There is a risk of re-tearing the repaired rotator cuff, which may require additional treatment or surgery.
  5. Patient may continue with ongoing physical therapy and follow-up appointments to monitor progress and prevent future injuries.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with arthroscopic rotator cuff repair surgery?
  2. What is the success rate of this surgery in terms of pain relief, range of motion improvement, and overall shoulder function?
  3. How long is the recovery process after arthroscopic rotator cuff repair surgery, and what can I expect in terms of rehabilitation and physical therapy?
  4. What factors may increase the risk of re-tearing the repaired rotator cuff, and how can I minimize this risk?
  5. Are there alternative treatment options to consider for severe rotator cuff tears, and how do they compare to arthroscopic repair in terms of outcomes?
  6. How many of these surgeries have you performed, and what is your success rate with this procedure?
  7. What is the expected timeline for returning to normal activities and sports after arthroscopic rotator cuff repair surgery?
  8. Will I need any additional imaging tests or follow-up appointments to monitor the healing process and check for re-tearing?
  9. Can you provide me with information on the rehabilitation protocol I will need to follow after surgery, including exercises and restrictions?
  10. Are there any specific lifestyle changes or modifications I should consider to protect my shoulder and prevent further injury after surgery?

Reference

Authors: Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, Schemitsch E. Journal: Arthroscopy. 2015 Dec;31(12):2472-80. doi: 10.1016/j.arthro.2015.06.038. Epub 2015 Sep 11. PMID: 26364549