Rotator Cuff Repair
Background
Arthroscopic rotator cuff repair restores the connection between a torn tendon and the bone of the upper arm. Dr. Fliegel performs the procedure through small incisions, using a camera to examine the shoulder and specialized instruments to repair the tendon while limiting disruption to the surrounding tissues.
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Dr. Fliegel tailors the repair to the tear pattern and tendon quality, using suture anchors to secure the tendon back to the bone. When appropriate, he may add a biologic augmentation patch to optimize healing. The same procedure also allows him to address related problems, such as biceps or labral injuries and bone spurs.
The Surgical Procedure
Rotator cuff repair is performed under general anesthesia, often with a nerve block to help control pain after surgery.
Surgical Technique
Dr. Fliegel examines the shoulder with a camera, prepares the area where the tendon attaches to bone, and uses high-strength suture anchors to secure the torn tendon back in place. The repair technique is tailored to the tear rather than using the same approach for every patient.
Repair Augmentation
For some tears, an augmentation implant or patch may be placed over the repaired tendon to provide additional support as it heals. Whether this is appropriate depends on the tear size, tendon quality, and findings during surgery.
Additional Procedures
Rotator cuff tears can occur alongside other shoulder problems. If needed, Dr. Fliegel may address a damaged biceps tendon, a labral injury, or other sources of pain during the same surgery. These findings and any additional procedures will be discussed as part of your surgical plan.
Recovery Timeline
A repaired tendon needs time to heal back to the bone. Rehabilitation therefore begins by protecting the repair, then gradually restores motion and strength. Your instructions may differ based on the size of the tear and the procedures performed.
Early Recovery (Weeks 1 - 6)
The main goals are to protect the repair and manage pain and swelling.
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Wear a sling as instructed, commonly for four to six weeks.
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Move your hand, wrist, and elbow as permitted.
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Avoid lifting, pushing, pulling, or using the operative arm to support your body weight.
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Begin physical therapy and protected shoulder motion according to your specific protocol.
Intermediate Recovery (Weeks 6 - 12)
Physical therapy focuses on regaining shoulder motion. Exercises progress from assisted movement toward moving the arm on your own, while the repair continues to heal.
Late Recovery (Months 3 - 6)
Strengthening becomes a greater focus. Daily tasks generally become easier as motion and shoulder control improve, although heavy lifting and strenuous activity may still be restricted.
Return to Activity (Months 6 - 12 and Beyond)
Many patients return to recreational sports and more demanding activities after six months or longer. The timing depends on tendon healing, strength, motion, and the demands of the activity. Improvement can continue for a year after surgery.
What to Expect
Pain Management
We utilize a multimodal approach including a nerve block when appropriate, oral medications, and ice therapy to minimize the postoperative pain and to limit narcotic use. Swelling and discomfort are expected early on, but most patients find their pain very manageable with this comprehensive approach.
Sleeping
Sleeping comfortably may be difficult early in recovery. Sleep often improves gradually and may take up to three months to return to normal. Many patients find it easier to rest in a recliner or with pillows supporting the arm and upper body.Â
Driving
Do not drive while wearing your postoperative sling or taking medication that affects your alertness. Ask Dr. Fliegel when you can safely resume driving.