“I’m Having a Rotator Cuff Repair…….what could possibly go wrong?”

“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.