Rotator Cuff Repair

Overview

Rotator cuff repair is an arthroscopic (minimally invasive) procedure to reattach torn rotator cuff tendons back to the bone. The surgery is performed through small 1 cm incisions using specialized instruments and a camera. This approach allows for precise repair while minimizing tissue damage and promoting faster recovery.

Dr. Kirsch utilizes the latest surgical techniques, including the use of high-strength suture anchors and biological augmentation patches when appropriate, to optimize healing and patient outcomes. The procedure addresses not only the rotator cuff tear but also any concomitant injuries such as labral tears, biceps tears, or bone spurs.

The Surgical Procedure

Rotator cuff surgery is performed under general anesthesia in addition to a nerve block for pain management. The procedure typically takes 1-2 hours depending on the extent of your rotator cuff damage.

Surgical Technique

Small 1 cm incisions are used to introduce specialized instruments into the shoulder. Suture anchors are placed in the bone first, allowing Dr. Kirsch to take high-strength sutures and tie the rotator cuff tendon back down to the bone from where it tore off.

Dr. Kirsch often uses special techniques including augmenting the rotator cuff repair with biological patches in the shoulder to help increase the likelihood of getting the rotator cuff to heal, thus optimizing patient outcomes.

Additional Procedures

Often, patients will have concomitant injuries in the shoulder such as labral tears, biceps tears, or bone spurs, all of which can be addressed at the same time without any additional incisions around the shoulder.

Recovery Timeline

Recovery from rotator cuff surgery is a slow and gradual process. Following surgery, you will be in a sling to help protect the rotator cuff repair.

Early Recovery (Weeks 1-6)

The main goals are to protect the repair and control pain. The rotator cuff is only 20% healed at 6 weeks, so protection is critical.

• Sling use for protection
• Pain management with multimodal approach
• Ice therapy (20 min on/off for 48-72 hours)
• Elbow/wrist motion allowed; no shoulder motion
• Physical therapy typically starts at 4-6 weeks

Intermediate Recovery (Weeks 6-12)

Focus on improving range of motion through passive motion exercises (the operative shoulder is not doing work on its own). Your physical therapist will instruct you on safe exercises to perform at home.

Late Recovery (3-6 Months)

Progressive strengthening begins as the rotator cuff continues to heal. Most patients experience significant improvement in pain and function during this phase.

Full Recovery (6-12 Months)

Return to full activity and sports. Most rotator cuff repairs achieve full maturation and healing by one year after surgery.

What to Expect

Pain Management

We utilize a multimodal approach including nerve blocks, oral medications, and ice therapy to minimize postoperative pain and narcotic use. Most patients find their pain very manageable with this comprehensive approach.

Vitamin D Supplementation

There is increasing evidence that Vitamin D plays an important role in tendon-to-bone healing. Starting at least 2 weeks before surgery, take 2,000 IU of Vitamin D3 daily and continue until 3 months after surgery.

Sleeping

Sleeping can be challenging after surgery. It may take up to 3 months for sleep patterns to normalize. Sleeping in an inclined position (recliner or wedge pillows) is often more comfortable.