Rotator cuff retears frequency

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Information from the American Academy of Orthopedic Surgeons

Rotator cuff surgery is like other surgery. All surgery is subject to risks and complications.

Some of these are minor, some are major. The minor risks from this form of surgery are from wound infection, which can occur in about 1% of patients. Wound infection will need to be treated promptly with antibiotics. Blood clots are extremely uncommon following shoulder surgery, occurring in about 0.1% of cases.

The major risk of rotator cuff surgery is breakdown of the repair. This means that the repair re-tears, either because the tendon is too weak to hold the stitches, or the bone is too weak, or if the stitches themselves break.

If the repair re-tears, a patient will have gone through surgery without any benefit and be as bad as when they started. The rate of re-tear depends upon how big the tear was. In tears less than 4 cms in length (the majority of tears) the re-tear rate is 10%, and in tears greater than 4 cms the re-tear rate climbs to as high as 30%.

Newer techniques have improved these figures.

One of the other major risks of rotator cuff repair is stiffness. Stiffness usually occurs because healing is too good. In this situation so much healing occurs that scar tissue develops which binds the shoulder to the shoulder blade (frozen shoulder). This can occur in 5 % of patients.

After surgery, rehabilitation with physiotherapy is necessary to recover and regain as much use of your shoulder as possible. The rate of recovery depends upon the size of the tear, and therefore the magnitude of surgery. The limiting factor is the secure healing of the reconstructed tendon to the bone which takes six weeks. This is the protective phase of recovery.

Patients with small and moderate tears will be in a sling for 3 weeks, and those with large and massive tears will be in a sling or splint for six weeks. Once the surgeon and physical therapist deem that the tendon has healed and that the shoulder is functional once more, range of motion exercises are started and then strengthening exercises. One should allow six months before he or she can comfortably raise their arms above shoulder level. They should allow twelve months before they can use their arms to do work at a level above the head with their original strength.

One note: For partial tears, ultrasound-guided needle tenotomy with platelet-rich plasma (PRP) is a minimally invasive method of healing rotator cuff tears. It has a high success rate and minimal recovery period.

For more information about rotator cuff tendonitis, visit our sister site:
Tendonitis provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

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