Arthroscopic rotator cuff surgery is an alternative to the more traditional open surgery to repair rotator cuff tears. While arthroscopic surgery is less invasive and there is less risk of damage to the surrounding tissue, the surgeon does need to be extensively trained on the procedure. The cost of the surgery could be an issue for some patients. Arthroscopic rotator cuff surgery has less risk than open surgery of morbidity, pain, and stiffness in the shoulder.
An arthroscopic repair is necessary when damage has occurred to the four muscles and surrounding ligaments that make up the network of the rotator cuff. The rotator cuff muscles are responsible for providing stability to the shoulder joint, and they allow for movement of the arm and shoulder. An injury to any of the four muscles of the rotator cuff can cause severe pain, limited range of motion, weakness, and inflammation and fluid build-up around the joint. A repair reattaches the muscles or tendons that have been torn during an injury. Surgery may also be needed to remove calcium deposits or scar tissue that has built up as a result of repeated injuries or inflammation.
After creating small 1 cm (0.4 inch) incisions in the skin around the location of the rotator cuff, the physician inserts small tubes that contain surgical instruments, lights, and a camera to perform arthroscopic rotator cuff surgery. A video screen in the operating room displays video from inside the shoulder. The surgeon explores and repairs the tear or reattaches the tendon to the bone by manipulating the instruments within the shoulder.
Open surgery, requires that at least a 6 cm (2.36 inch) incision be made, and that the layers of the deltoid muscle covering the rotator cuff are separated to allow the surgeon to visualize the tear. This muscle separation causes the recovery time to be longer and creates a greater risk that damage will occur during the procedure to the surrounding muscles structures. The arthroscopic method also allows the operating physician to visualize other areas of the shoulder through the use of the cameras that would not visible to the naked eye during the open method.
Recovery time for an arthroscopic rotator cuff surgery is comparable to open surgery, as the muscle or ligaments that have been reattached will still need adequate time to heal. The patient will need to wear a sling for nearly a month following the procedure, after which a physical therapist will begin to work with the patient to rehabilitate the shoulder. Range of motion exercises and weight lifting will be slowly introduced in the following months. The pain associated with the arthroscopic method is usually less, as the incisions are smaller and there is no need to split the overlying muscles.
