Our Summary

This research paper discusses the issues around a common shoulder injury called a rotator cuff tear. Even though surgical techniques have improved, there’s a high chance of the injury happening again after surgery. This is mainly because the scar tissue that forms between the tendon and bone isn’t as strong as the original tissue. Many researchers are now studying how to improve the healing of the tendon to the bone and how to restore the original structure. The paper looks at four factors that may affect healing: inflammation, slow or limited bone growth into the tendon graft, mechanical stimulation, and a lack of stem cells. It also considers the role of physiotherapy in recovery.

FAQs

  1. Why is there a high chance of a rotator cuff tear reoccurring after surgery?
  2. What are the four factors that may affect the healing of a tendon to the bone after a rotator cuff repair?
  3. What is the role of physiotherapy in the recovery process after a rotator cuff repair?

Doctor’s Tip

One helpful tip a doctor might give a patient about rotator cuff repair is to follow a strict rehabilitation program after surgery. This may include physical therapy exercises to strengthen the muscles around the shoulder joint, improve range of motion, and prevent stiffness. It is important to follow the guidance of your healthcare team and not rush into activities that could potentially re-injure the repaired tendons. Consistent and dedicated rehabilitation can greatly improve the chances of a successful recovery and reduce the risk of future injuries.

Suitable For

Patients who are typically recommended for rotator cuff repair surgery are those who have a significant tear in their rotator cuff tendon that is causing persistent pain, weakness, and limited range of motion in the shoulder. These tears can be caused by acute injuries, such as a fall or sudden impact, or they can develop over time due to repetitive overhead movements or degenerative changes in the tendon.

Patients who have tried conservative treatments, such as physical therapy, anti-inflammatory medications, and corticosteroid injections, without significant improvement in their symptoms may also be candidates for surgery. Additionally, patients who have a complete tear of the rotator cuff tendon or who have a large tear that is causing significant functional impairment may be recommended for surgical repair.

It is important for patients to undergo a thorough evaluation by a healthcare provider, such as an orthopedic surgeon or sports medicine physician, to determine the best course of treatment for their specific injury. The decision to undergo rotator cuff repair surgery should be made in collaboration with the patient’s healthcare team, taking into consideration the severity of the tear, the patient’s overall health and activity level, and their treatment goals.

Timeline

Before rotator cuff repair:

  1. Patient experiences shoulder pain, weakness, and limited range of motion.
  2. Patient undergoes diagnostic tests such as MRI to confirm the rotator cuff tear.
  3. Patient may undergo non-surgical treatments such as physical therapy, corticosteroid injections, and rest.
  4. If non-surgical treatments are not effective, patient may opt for rotator cuff repair surgery.

After rotator cuff repair:

  1. Patient undergoes surgery to repair the torn rotator cuff tendon.
  2. Patient typically wears a sling for a period of time to protect the shoulder and allow for healing.
  3. Patient begins physical therapy to regain strength and range of motion in the shoulder.
  4. Patient may experience pain and discomfort during the initial stages of recovery.
  5. Over time, patient gradually improves and regains function in the shoulder.
  6. Full recovery can take several months to a year, with ongoing physical therapy and rehabilitation.
  7. Patient may need to make lifestyle changes to prevent re-injury, such as avoiding repetitive overhead movements or heavy lifting.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rotator cuff repair include:

  1. What are the risks and complications associated with rotator cuff repair surgery?
  2. What is the success rate of rotator cuff repair surgery in terms of pain relief and function improvement?
  3. How long is the recovery period after rotator cuff repair surgery and what is the expected timeline for returning to normal activities?
  4. Are there any alternative treatments or therapies that could be considered instead of surgery?
  5. What type of rehabilitation or physiotherapy will be needed after surgery to aid in the healing process?
  6. How can I prevent re-injury or further damage to my rotator cuff in the future?
  7. Are there any specific lifestyle changes or modifications I should make to support the healing process?
  8. What are the long-term implications of a rotator cuff tear and repair surgery on my shoulder function and mobility?
  9. How frequently should I follow up with my doctor after surgery to monitor my progress and address any concerns?
  10. Are there any specific exercises or activities I should avoid in order to prevent complications or setbacks in my recovery?

Reference

Authors: Cao YS, Wan YF. Journal: Zhongguo Gu Shang. 2018 Dec 25;31(12):1172-1179. doi: 10.3969/j.issn.1003-0034.2018.12.020. PMID: 30583662