SHOULDER ARTHROSCOPY

Q: I have heard that recovery from rotator cuff surgery takes some time. Why is that?

A: The critical component to a successful outcome from rotator cuff surgery is a robust healing response and sound structural integrity at the repair site. A major factor in that integrity is meticulous arthroscopic surgical technique and the skill of the surgeon. However, in even the most technically well-performed surgeries complete rotator cuff healing is not a guarantee. A host of additional factors, some related to the patients themselves and others related to the approach to postoperative recovery can ultimately determine success or failure.

Patient characteristics such as tear size, how chronic the tear is, other medical conditions such as diabetes and smoking can all impact healing and surgical outcome. Overly aggressive physical therapy or premature return to use of the surgically repaired shoulder can also be detrimental to healing. As our understanding of rotator cuff tendon to bone healing has evolved, so has our approach to rehabilitation and return to use and an appreciation that a less is more and slow and steady philosophy results in the best outcomes. An overzealous desire to “get back to normal” can compromise the healing tendon and if the rotator cuff tendon fails to heal the results will suffer. Because of this, for the first 4 to 6 weeks of recovery most surgeons who perform a high volume of rotator cuff surgery and have the greatest knowledge of state of the art rehabilitation protocols will permit little or no shoulder movement, even with the supervision of a physical therapist, and sling immobilization. After this initial period of maximum protection there is a slow progression of range of motion exercises and ultimately strengthening that typically requires another 3-4 months to achieve optimal results. Successful rotator cuff surgery requires full commitment from the patient and an understanding that investment in near term protection gives the best chance for long term satisfaction.

To learn more about rotator cuff repair surgery visit ohioshouldercenter.com Eric M. Parsons, M.D. Ohio Shoulder Center for Arthroscopy Lake Orthopaedic Associates, Inc. 36060 Euclid Ave., Suite 104 Willoughby 440-942-1050 9500 Mentor Ave., Suite 210 Mentor 440-352-1711 www.ohioshouldercenter.com