Arthroscopic surgery for Rotator cuff tear

Shoulder Fractures or Injuries

Dislocation or Subluxation of Shoulder

Shoulder Deformity

Stiff and Swollen Shoulder

Pain and Swelling in Shoulder

Shoulder Soreness and Ache

Significantly reduced Shoulder function

Bony Enlargements in Shoulder

Shoulder Infections

Shoulder Tumour

Shoulder Trauma

Fatigue, Weight Loss & Fever

Introduction

The shoulder is the most flexible joint in our body and it is used for all types of hand movements like rotating, working, cooking, lifting things, raising arms and all the daily activities. The shoulder joints are connected by a group of 4 muscles and their tendons called the rotator cuffs, which help the work be smooth and flexible. These muscles keep the upper arm bone (humerus) attached to your shoulder blade (scapula) and provide stability and mobility.

But sometimes these rotator cuff muscles may face injuries or damage because of overuse or intense sports activities like throwing or lifting or due to ageing. As a result, the cuff muscles get torn and won’t be able to heal well with medications or physical exercises. You will have severe pain and won’t be able to move your arms at all. In such situations your doctor might advise you to get a cuff repair.

What is Arthroscopic Rotator Cuff Repair?

Rotator cuff repair becomes a necessity when the tendons are torn or extremely injured. If your rotator cuff doesn’t respond to non-surgical treatments like medications, or you have severe shoulder pain while losing mobility, then surgery becomes mandatory to repair it. 

There are two ways in which cuff repairs are done, either by arthroscopy or through open surgery. We are looking at the arthroscopic way to repair rotator cuffs. For large injuries where the tears cannot be repaired, the surgeon does an SCR (superior capsular reconstruction) where a tissue graft is used to reconstruct the superior capsule of the shoulder.

Arthroscopic methods are very popular among orthopaedic surgeons nowadays, as they involve only minimal incisions and inserting a camera to find out the actual issue on screen. With the clear visuals from the camera on an external screen, the repairs are performed by the doctor using surgical tools. The doctor also uses methods like tendon transfer or in severe cases, the patient would need a reverse total shoulder replacement.

Arthroscopic rotator cuff repair involves arthroscopy performed in the shoulder joints. A surgery done this way would help your shoulder get complete relief from pain in the joints and heal the rotator cuff tears.

Dr. Bharani Kumar Dayanandam is a well-regarded orthopaedic surgeon at Chennai Orthopaedics and brings with him over 21 years of experience and expertise in shoulder surgeries, especially the arthroscopic rotator cuff repair.

Common Causes of Rotator Cuff Tears

The rotator cuff might get injured due to various reasons.  They could be due to overuse of your shoulders in your job, accident, intense hand use in sports like cricket, tennis, etc., or age-related degeneration of muscles. Either way, your tendons might face a tear, causing an extreme condition which would need medical intervention. 

While the common causes are due to the above-mentioned issues, the major causes are shoulder dislocations or any other traumatic injuries. If it is not given timely treatment, it may cause severe pain, loss of strength and degenerative issues. 

Why Choose Arthroscopic Surgery for Rotator Cuff Tears?

Rotator cuff tears are usually mechanical concerns and medications might not help a patient to a great extent except for giving sudden pain relief. But the problem keeps continuing; hence, surgical correction is the only option to repair cuff tears.

However, in some cases steroids may be administered when the pain becomes unbearable, but it comes with its own risks.

If you have a constant pain in your shoulders, there might be a chance that the tendons are torn and might never heal with medications. In those situations you must be recommended to get a surgery.

Arthroscopic surgery is a very reliable and minimally invasive procedure where only small surgical instruments are used to repair the damage. Hence, you will have only minimal pain, or cuts, or sutures involved, unlike open surgery.

Benefits of Arthroscopic Surgery for Rotator Cuff Tears

There are a lot of benefits from arthroscopic shoulder surgery, like

  • It is minimally invasive and involves very small cuts and quicker healing.
  • There is very little pain and scarring, as it doesn’t disturb any surrounding tissues.
  • Fast recovery with a quick return to your normal routine.
  • Very less risk of infections or other complications, unlike traditional surgery.
  • Less joint stiffness 

The Procedure – How Arthroscopic Rotator Cuff Repair is Performed

Before the procedure

Like in any surgical procedure, the doctor will evaluate your concerns in detail and check your medical history and whether you are taking any medications. 

Once the evaluation is done, you will be given specific guidelines, like getting your blood work done, a chest X-ray and an ECG. Some patients would need an MRI scan to evaluate the severity of the damage. You might have to stop eating and drinking some hours before the surgery as recommended by your doctor.

During the procedure

  • Just before beginning the procedure, the patient will be given general or regional anaesthesia.
  • The patient will be made to lie on their side or a beach chair position. The shoulder in which the surgery is done will be facing the doctor. One or more small incisions will be made on the skin of the shoulder joint.
  • The arthroscope will be inserted through those cuts. The doctor will be able to view the inside of the area on the computer screen in the operating room.
  • Small surgical instruments will be inserted into the cut and the injured tissue or damaged parts of the tendon will be removed.
  • The remaining tendon parts are stitched together without damaging nerves or blood vessels.
  • The torn tendons should be reattached to the bone, and it is done with the help of a suture anchor.
  • With that the procedure gets over, and the incisions are closed, and bandages are applied to cover them to prevent infections and help fast healing.

Who Should Consider an Arthroscopic Rotator Cuff Repair?

You might be a good candidate for arthroscopic shoulder surgery if

  • You have had shoulder pain for more than six months and failed to respond to physiotherapy.
  • Your shoulder movements are restricted.
  • Your daily activities get severely affected.
  • You have lost strength in your shoulders.
  • You have large tears that are difficult to heal naturally.
  • You had an open surgery earlier but tendons got torn.

What to Expect After Surgery?

Once the surgery is over, your shoulder will be kept in a sling to stop moving the same. Pain and inflammation management will be done through non-steroidal drugs. Most arthroscopic procedures are done in an outpatient category and will be done within 1-2 hours depending on the size and severity of the injury. The patients will be able to return home the same day after some time.

The pain might persist for some days and the medications will have to be continued as per the doctor’s instructions. Ice applications are also usually recommended to reduce swelling or pain. It is very important to adhere to the guidelines given by your doctor about aftercare measures. The recovery period might range from weeks to months. 

Why Choose Dr. Bharani Kumar Dayanandam for Arthroscopic Rotator Cuff Repair?

Dr. Bharani Kumar Dayanandam is a well-known orthopaedic surgeon and trauma consultant at Chennai Orthopaedics and brings with him over 26 years of experience in arthroscopic rotator cuff repair. He is also an expert in arthroscopic knee joint surgeries, ACL/PCL/MCL, meniscus implants, patella realignments, joint arthroplasty, osteotomy, and shoulder stabilisation.

Apart from being an MBBS graduate, Dr. Bharani Kumar is also an Associate Fellow (AFRCSI) of the Royal College of Surgeons, Ireland. He did an AFRCSI in 2001 and also achieved a Diploma in Orthopaedic Engineering from the University of Cardiff, Wales, in 2004. He also did an FRCS in Trauma and Orthopaedics in 2010 as well.

If you are looking for the best shoulder surgeon in Chennai for arthroscopic rotator cuff repair, then Dr. Bharani Kumar Dayanandam is the trusted choice.

FAQs

What is arthroscopic rotator cuff repair?

It is a very minimally invasive surgical procedure that makes use of only small incisions and a camera to repair the damaged or torn shoulder tendons.

How long does it take to recover from rotator cuff surgery?

Normally a recovery from rotator cuff surgery takes around 3-6 months. But it depends on the type of damage and its severity with the rehabilitation response.

How much does rotator cuff surgery cost in Chennai?

Ideally the costs for rotator cuff surgery in Chennai range from Rs 80,000 to Rs 2,50,000 but they vary substantially in different hospitals due to several factors.

What are the benefits of arthroscopic rotator cuff repair?

The benefits include fewer cuts, less scarring or pain and faster healing with an improved functioning shoulder.

When should I consider rotator cuff surgery?

If you have severe pain, loss of strength, are not able to move or lift your hands overhead, or show no improvement with medicines or physiotherapy, then you might be recommended to undergo the surgery.