Rotator Cuff Repair Surgery & Treatment in India

A rotator cuff tear is a common cause of pain and disability among adults.The rotator cuff is a group of 4 tendons that work together to support and stabilize the shoulder joint , each tendon connects muscle to bone , when one or more tendons become damaged , arm loses strength and mobility .

The rotator cuff tendons cover the head of humerus helping to raise and rotate the arm .In most rotator cuff tears, the tendon is torn away from the bone.

Types of Rotator Cuff Tears

• Acute Tear-If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff.
• Degenerative Tear- Most tears are the result of a wearing down of the tendon that occurs slowly over time. This degeneration naturally occurs as we age.
• Partial tear–This type of tear is also called an incomplete tear. It damages the tendon , the tendon no longer fully attaches to the head of the humerus.
• Full-thickness tear–This type of tear is also called a complete tear,  With a full-thickness tear, there is basically a hole in the tendon.

Symptoms of Rotator Cuff Tears

• Pain at rest , specially if lying on the affected shoulder
• Pain  and weakness when lifting and rotating  arm
• crackling sensation during shoulder movements  in certain positions

Diagnosis

• Medical History –The physician will discuss your symptoms and medical history.
• Physical Examination – physician will check tenderness, measure the range of motion of your shoulder, also will  test your arm strength.
• Imaging Tests-  these  tests aid in confirming the diagnosis
• Magnetic resonance imaging (MRI) –  can show soft tissues like rotator cuff as well as where the tear is located within the tendon and the size of the tear.

Procedure for Rotator Cuff Repair Surgery

The type of repair performed depends on several factors considering type of tear, age, activity level, general health, surgeons experience with  a particular procedure. The surgeon  will discuss with you the best procedure to meet your individual health needs.

Techniques most commonly used for rotator cuff repair include

• Open repair,
• Arthroscopic repair
• Mini-open repair.

1. Open repair – An open surgical incision is performed  if the tear is large or complex. The surgeon makes the incision over the shoulder and detaches one of the shoulder muscles (deltoid) to gain access to the torn tendon.
2. Arthroscopic Repair-This is less invasive procedure. During arthroscopy, surgeon inserts a small camera, called an arthroscope, into shoulder joint to guide through the surgery , other miniature surgical instruments are inserted  to repair the torn rotator cuff.
3. Following the repair fluid allowed to drain from shoulder, sterile bandage is applied In order to keep the shoulder muscle immobile while it heals a sling is provided .
4. Mini-Open Repair Repair is performed through a small incision. The incision is  typically  3 to 5 cm long. While performing the tendon repair, the surgeon views the shoulder structures directly, rather than through the  monitor.

Recovery

Complete recovery may take several months.

• Pain Management– After surgery, you will feel pain which will be controlled by use of NSAIDs
• Rehabilitation- Rehabilitation is important  in getting you back to your daily activities. Physiotherapy will help you regain shoulder strength and motion.
• Immobilization –initially the repair needs to be immobilized while the tendon heals , to avoid using your arm for the first 4 to 6 weeks you will be given a sling
• Passive exercise- Usually,  passive exercise are started within the first 4 to 6 weeks after surgery.
• Active exercise- After 4 to 6 weeks, you will be doing active exercises.

Factors Affecting Cost Of Rotator Cuff Repair Surgery

The cost to the patient depends on a variety of factors like:

• The hospital, the patient chooses.
• Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
• Fee for the team of doctors and OT charges
• Standard test and diagnostic procedures.
• Cost of the follow –up care required after the procedure
• Physiotherapist cost