Rotator Cuff Repair - Arthroscopic Surgery PreOp® Patient Education

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Before we talk about treatment, let's start with a discussion about the human body and about your medical condition.

Your doctor has recommended that you have surgery to repair a torn rotator cuff. But what does that actually mean?
Rotator cuff is the term given to describe a group of four tendons that work together to support and stabilize the shoulder joint.
Each tendon connects muscle to bone.
When a shoulder muscles contracts, it pulls on a tendon which in turn pulls on the upper arm bone and causes it to move.
When one or more of these tendons become damaged, the arm loses strength and mobility.

So make sure that you ask your doctor to carefully explain the reasons behind this recommendation.
Now it's time to talk about the actual procedure your doctor has recommended for you.

On the day of your operation,
... you will be asked to put on a surgical gown.
You may receive a sedative by mouth ...
... and an intravenous line may be put in.
You will then be transferred to the operating table.
In the operating room, a nurse will begin preparation by clipping or shaving your shoulder.
If you are receiving general anesthesia, the anesthesiologist will administer it by injection and using an inhalation mask.
The surgeon will then apply an antiseptic solution to the skin...
... and place a sterile drape around the operative site.
To perform arthroscopic surgery your doctor will make three small, button-hole sized incisions in the area around the shoulder.
An arthroscope is essentially a very small video camera that your doctor will use to guide the surgery. Before your doctor can insert the arthroscope, the surgical team will inject a clear fluid into the joint. This fluid will inflate the interior space around the surgical site and will help your doctor by providing an unobstructed view and enough room in which to work.Patient Education
Your doctor will insert the arthroscope and inspect the surgical site.
If he or she decides that the team can proceed with the arthroscopic procedure, other small surgical instruments will be inserted through the other small openings.
First, your doctor will use a burr file to file away any rough edges on upper part of the shoulder bone called the acromion.
Under the deltoid muscle lies the bursa, a protective sac that prevents the rotator cuff tendons and the shoulder muscles from rubbing against each other.
Using a shaving instrument, you doctor will cut away the bursa to gain access to the damaged tendons.Patient Education
Next, the surgeon will cut away any scar tissue or unhealthy tissue around the torn area.
Using sutures, the tear can now be repaired. One instrument places the sutures.
And then a second instrument fixes them in place.
When your doctor is satisfied that all possible repair has been completed,
... the instruments are removed and the clear fluid is allowed to drain from the shoulder.
Finally, a sterile bandage is applied. In order to keep the shoulder muscle immobile while it heals, you will be given a sling to wear.

Rotator cuff surgery only rarely leads to complications.
In some cases, this kind of procedure can result in persistent residual neuralgia -- or pain -- around the incision sites.
It can be either localized or general.
It may develop soon after surgery -- or even weeks or months later.
In rare cases, the surgery does not restore full mobility or strength to the arm.
When this occurs, it is usually because the rotator cuff tendons were damaged in ways that surgery could not fully repair.
Patient Education
Once you return home, you will be responsible to keeping the dressing intact and clean.

As with all surgery, you should be alert for signs of infection near the incision - increased swelling, redness, bleeding or other discharge. Your doctor may advise you to be on the alert for other symptoms as well. If you experience any unusual symptoms, report them to your doctor right away.

You may also notice some bruising in the general area of the incision. The discoloration may be extensive - but as with any bruise, it should heal on it's own.
Patient Education
Before you leave, you'll be given discharge guidelines which may include diet, medication, work and other activity restrictions.

You'll also make at least one follow-up appointment so that the doctor will be able to check the healing of the incision and/or to remove sutures.






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