Timing of the
surgery
Before cuff surgery is
undertaken, the patient needs to:
-
be in optimal health,
-
understand and accept the risks and
alternatives of surgery, and
-
understand the post-operative
rehabilitation program.
In cases of chronic cuff tears, rotator cuff
surgery can be performed whenever conditions
are optimal. Sometimes the pain and
stiffness from rotator cuff disease will
stabilize at a level that is acceptable to
the patient. In such cases the patient can
delay surgery without compromising the
potential for future surgery, as long as the
surgeon monitors the cuff tear to make sure
it is not enlarging. Sequential shoulder
ultrasound is particularly useful in
sequentially following the integrity of the
cuff.
In the case of an acute rotator cuff tear in
otherwise healthy tissue, the best chance of
achieving an excellent result is surgical
repair within the first month after the
tear, but this depends largely on the
severity of the tear.
Plan ahead
After rotator cuff repair, the patient needs
to plan on being less functional than usual
for six to twelve or more weeks after the
procedure. The shoulder should not be used
with the elbow away from the side for 6
weeks after a rotator cuff repair. Lifting,
pushing, pulling, and many activities of
daily living place stresses on the rotator
cuff and can place excessive tension on the
cuff repair, risking failure of the repair.
Driving, shopping, and performing usual work
or chores may be difficult during this time.
Plans for necessary assistance need to be
made before surgery. For people who live
alone or those without readily available
help, arrangements for home help should be
made well in advance.
This information has been acknowledged to
Frederick A. Matsen, III, M.D. but altered
for local and current relevance.
