What Can Go Wrong in a Rotator Cuff Surgery?

The rotator cuff is a group of tendons and muscles in the shoulder which allow you to rotate and lift your arm and keeps your shoulder joint in place. Problems are generally caused in the rotator cuff either through injury, such as falling on your arm during a sports activity, or through wear and tear over time. The pain experienced from rotator cuff problems can be mild to severe.

When is surgery needed for a rotator cuff?

Sometimes, rotator cuff tears can heal on their own. Conservative treatment of rotator cuff problems begins with resting and icing the area when you are experiencing pain. If the problem does not improve, however, surgery may be required. Surgery should be considered if:

• Shoulder pain continues for 6 to 12 months
• You are losing strength in your shoulder and the pain is not decreasing
• There is a large tear in the rotator cuff that is 1 inch or longer
• You are active and rely on your shoulder strength for your job or for sports

If surgery is needed, the procedure can take place in hospitals or outpatient care facilities. Recovery will likely mean wearing a sling for 6 weeks and you may not be able to drive for a month. This will give your rotator cuff time to rest and heal properly.

What can go wrong during rotator cuff surgery?

How invasive rotator cuff surgery is, depends on the procedure. Arthroscopic repair involves the surgeon making two very small cuts in your skin in order to insert a small camera called an arthroscope. This gives the surgeon the ability to see which parts of the rotator cuff are damaged and the safest way to fix them. Open tendon repair, however, is more invasive but has been practiced for longer. If you have a large rotator cuff repair, this is the likely route your orthopedic surgeon will take. 

Both procedures do have risks of complications. Any surgery which involves anesthesia poses a slight risk of stroke, heart attack, pneumonia or blood clotting. Some patients may choose to stay conscious during rotator cuff surgery and simply have the area of operation numbed instead of going completely under, in order to mitigate these risks.

Occasionally, rotator cuff surgery causes damage to adjacent nerves and blood vessels. One study concluded that 1 to 2% of patients experience nerve damage. A very small percentage of individuals, about 0.16 to 1.9% of patients, experience deep infection after arthroscopic or mini-open surgery. Stiffness is relatively likely after open rotator cuff surgery and is experienced by about 20% of patients, ending about 6 to 12 months after successful surgeries. Sometimes, patients might tear their rotator cuff repairs after surgery. This is more common in patients undergoing larger rotator cuff tear repairs. 

What can go wrong during recovery from rotator cuff surgery?

There are a number of factors that will determine how long and how successful recovery will be from rotator cuff surgery. Recovery from arthroscopic surgery typically takes less time and is less painful than open tendon repair. Larger tendon repairs will naturally have a longer healing time. The location of the tear can also indicate how long it will take to heal, as tears along the backside portion of the shoulder generally demand more care and limited shoulder rotation. Tissue quality of the patient can also determine how long recovery will take, as well as lifestyle factors and pre-existing health issues. 

For a successful recovery, adept physical therapists are a must after rotator cuff surgery. Patients using proficient physical therapists have shown significant rates of improvement than those using home therapy programs for recovery.

Orthopedic Corner | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201  Naples Florida 34102 | Phone: (239) 262-1119