“I’m Having a Rotator Cuff Repair…….what could possibly go
wrong?”
Rotator cuff repair surgery is one of the most common and
successful orthopaedic operations. Most patients tell me that they feel that
their shoulder is at least 90% of normal after they have recovered. However, as
with any surgery things can go wrong. Thankfully that is not common but if you
are having a rotator cuff repair surgery you should be aware of the potential
complications. Here is a list of the most common ones.
1.
Stiffness:
Most patients will have some mild stiffness after a rotator cuff repair, and
this will gradually loosen up with physical therapy. This stiffness is normal
and is caused by scar tissue that forms around the shoulder. Unfortunately,
some patients will have severe stiffness that can be very bothersome, and
prevent them from regaining normal motion. This is referred to as a “frozen
shoulder”. I would estimate that approximately 5% of patients encounter this
problem after a rotator cuff repair. It tends to occur more commonly in younger
patients (less than 55) and patients who have a small tear repaired.
If a patient does have a post-operative
frozen shoulder the first step is try to address the problem with physical
therapy and stretching. Sometimes a cortisone injection can also help. If the
shoulder does not “loosen up” after at least 3 months of therapy and
stretching your surgeon might consider a
second procedure to break up the scar tissue in your shoulder and improve your
motion.
2.
Re-tear
of the rotator cuff: During a rotator cuff repair the tendon is reattached
to the bone. Unfortunately, in some instances the tendon may re-tear. When this
happens it is usually because of “biologic” reasons meaning that the patient’s
rotator cuff tissue was not strong or of good quality. A re-tear is more common
in patients who are over 65 years old, patients with massive tears, and
smokers.
The good news about re-tears is that even
if this occurs most patients can still get a very good result and benefit
greatly from their surgery. In fact, some studies have shown that patients who
have a re-tear do just as well as those who do not! However, if a re-tear
causes pain and weakness a revision surgery could be considered.
3.
Nerve
Injuries: Thankfully, this is a very rare complication following shoulder
surgery. But when it does occur it can be disastrous for the patient. I have
published a paper on this topic from the Mayo Clinic’s experience. If you have
suffered a nerve injury following a shoulder surgery a surgeon with knowledge
of these problems should evaluate you as soon as possible.
4.
Infection:
As with any surgery infections can happen following rotator cuff repair. It is
not common. Symptoms include fever, persistent redness or drainage from your
incision sites. This might require antibiotics and a surgery to clean out the shoulder.
If you would like a consultation
regarding your rotator cuff tear, nerve injury, shoulder replacement or other
shoulder diagnosis you can contact Dr. Brad Carofino at carofinob@atlanticortho.com.
Dr. Carofino sees patients in
Virginia Beach and Chesapeake, Virginia.
