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Acute Tear-If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff.
Degenerative Tear- Most tears are the result of a wearing down of the tendon that occurs slowly over time. This degeneration naturally occurs as we age.
Partial tear-This type of tear is also called an incomplete tear. It damages the tendon , the tendon no longer fully attaches to the head of the humerus.
Full-thickness tear-This type of tear is also called a complete tear, With a full-thickness tear, there is basically a hole in the tendon.
Pain at rest , specially if lying on the affected shoulder
Pain and weakness when lifting and rotating arm
crackling sensation during shoulder movements in certain positions
Diagnosis
Medical History -The physician will discuss your symptoms and medical history.
Physical Examination – physician will check tenderness, measure the range of motion of your shoulder, also will test your arm strength.
Imaging Tests- these tests aid in confirming the diagnosis
The type of repair performed depends on several factors considering type of tear, age, activity level, general health, surgeons experience with a particular procedure. The surgeon will discuss with you the best procedure to meet your individual health needs.
Techniques most commonly used for rotator cuff repair include
Open repair,
Arthroscopic repair
Mini-open repair.
Open repair - An open surgical incision is performed if the tear is large or complex. The surgeon makes the incision over the shoulder and detaches one of the shoulder muscles (deltoid) to gain access to the torn tendon.
Arthroscopic Repair-This is less invasive procedure. During arthroscopy, surgeon inserts a small camera, called an arthroscope, into shoulder joint to guide through the surgery , other miniature surgical instruments are inserted to repair the torn rotator cuff.
Following the repair fluid allowed to drain from shoulder, sterile bandage is applied In order to keep the shoulder muscle immobile while it heals a sling is provided .
Mini-Open Repair Repair is performed through a small incision. The incision is typically 3 to 5 cm long. While performing the tendon repair, the surgeon views the shoulder structures directly, rather than through the monitor.
Complete recovery may take several months.
Pain Management- After surgery, you will feel pain which will be controlled by use of NSAIDs
Rehabilitation- Rehabilitation is important in getting you back to your daily activities. Physiotherapy will help you regain shoulder strength and motion.
Immobilization –initially the repair needs to be immobilized while the tendon heals , to avoid using your arm for the first 4 to 6 weeks you will be given a sling
Passive exercise- Usually, passive exercise are started within the first 4 to 6 weeks after surgery.
Active exercise- After 4 to 6 weeks, you will be doing active exercises.
The cost to the patient depends on a variety of factors like:
The hospital, the patient chooses.
Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
Fee for the team of doctors and OT charges
Standard test and diagnostic procedures.
Cost of the follow –up care required after the procedure
Physiotherapist cost
Shoulder Rotator Cuff Procedure: 4.32 Min