Full Thickness Rotator Cuff Repair
If you are experiencing shoulder pain and weakness, it could be a sign of a full-thickness rotator cuff tear. Full-thickness tears of the rotator cuff occur when one or more tendons that make up the rotator cuff tear completely through (off the bone). This results in pain, limitation in motion, and weakness in the shoulder.
Some patients with full-thickness tears may experience relief with nonsurgical treatment, such as modifying activities, physical therapy, home exercises, and injections but these treatments do not “get rid of” or heal the tear and therefore can lead to inferior outcomes compared with surgical repair. Surgical treatment for full-thickness tears has largely become the gold standard for full-thickness tears and is performed with a scope, which is a long thin camera inserted through tiny incisions as an outpatient procedure. Surgical treatment for these injuries has been shown to result in better outcomes and improved function in most patients(1).
By reattaching the tear in the rotator cuff to the bone, the pain and functional loss from the tear will improve and further damage (tear enlargement) can be prevented. Because full-thickness tears can worsen, it is important these tears are diagnosed early and at least monitored closely for worsening if they are not repaired.
Dr. Obermeyer specializes in the treatment of full-thickness tears and has helped many patients achieve significant improvements in their shoulder function and quality of life. Dr. Obermeyer uses the latest arthroscopic techniques and tools to minimize damage to the surrounding tissues and to accelerate recovery.
There is high quality scientific literature consisting of randomized controlled data demonstrating that primary repair is superior to physical therapy for small and medium-sized (<2.5cm) full-thickness tears(1). Patients managed surgically have substantially better outcomes at ten-year follow up as determined by validated function scores, pain assessment, and mobility testing than patients managed with physical therapy(1). Notably, patients managed with non-surgical treatment and physical therapy can often expect a gradual functional decline which may be due to increasing tear size and fatty atrophy of the muscle-tendon unit(2).
Choosing an experienced surgeon that specializes in the treatment of full-thickness tears is important because not all rotator cuff repairs heal. Evidence supports that surgical volume and experience are critical factors in tendon healing and limiting the need for revision surgery(3). Dr. Obermeyer treats a high volume of rotator cuff tears, including those that have been treated previously by other surgeons (called revisions), and is very well versed in the nuances of treating them with the scope so that they will heal once repaired.
Dr. Obermeyer is actively involved in advancing the treatment of full-thickness rotator cuff tears and is an associate reviewer for the Journal of Shoulder and Elbow Surgery, where many of the studies evaluating techniques and outcomes of surgery are published. He also teaches other surgeons how to repair rotator cuff tears using the latest techniques and advancements. This commitment to excellence in patient care and surgical technique is what sets Dr. Obermeyer apart and why many patients seek his expertise for the treatment of their rotator cuff tear.
Surgery to repair a torn rotator cuff is done as a minimally invasive arthroscopic procedure while you are asleep with anesthesia. The procedure is done under a nerve block where you awaken with a numb shoulder and leave the facility within an hour or two with your arm in a sling. The sling is maintained for several weeks to let the tendon repair heal, but you can use your hand for simple activities while the shoulder is healing. Most patients require a pain medication for a few days to a week or two after the surgery. You can shower shortly after the surgery with your arm at your side.
Most patients can resume driving after a couple weeks with the sling in place, as long as they feel comfortable driving with the arm in a sling and as long as they are not taking pain medications. You can resume office work within a few days of surgery and some patients will resume sedentary activities at the workplace a week or two after surgery.
Generally physical therapy is recommended for several weeks to ensure the motion and strength returns to the shoulder and to ensure you achieve an optimal outcome. Patients will resume almost all activities within three months of the procedure when they are generally highly satisfied with the results of surgery, are sleeping through the night, and are well along their way to a full recovery.
The primary risks of rotator cuff repair are anesthetic or medical risks inherent to any surgery, non-healing of the repair, stiffness of your shoulder, or need for further surgery. Rare events include infection, bleeding, or nerve injury. Because there are risks of any surgery, it is important to treat with an expert surgeon like Dr. Obermeyer to minimize your risks and optimize the chance for a successful outcome.
If you are experiencing shoulder pain and weakness, do not wait to seek attention. Full-thickness rotator cuff tears require prompt treatment and evaluation to prevent further damage and improve outcome. Contact Dr. Obermeyer today to schedule a consultation and take the first step toward regaining your function and quality of life.
Schedule a shoulder exam
If you have symptoms consistent with a rotator cuff tear, call our office or book an appointment with shoulder surgeon Dr. Thomas Obermeyer. Dr. Obermeyer specializes in diagnosing and treating rotator cuff injuries. Dr. Obermeyer has orthopedic offices in Schaumburg, Bartlett, and Elk Grove Village, Illinois. Dr. Obermeyer regularly sees patients from throughout Illinois including Hoffman Estates, Palatine, Elgin, Streamwood, Arlington Heights, and Roselle communities.
References
- Moosmayer S, Lund G, Seljom US, Haldorsen B, Svege IC, Hennig T, Pripp AH, Smith HJ. At a 10-Year Follow-up, Tendon Repair Is Superior to Physiotherapy in the Treatment of Small and Medium-Sized Rotator Cuff Tears. J Bone Joint Surg Am. 2019 Jun 19;101(12):1050-1060. doi: 10.2106/JBJS.18.01373. PMID: 31220021.
- Melis B, DeFranco MJ, Chuinard C, Walch G. Natural history of fatty infiltration and atrophy of the supraspinatus muscle in rotator cuff tears. Clin Orthop Relat Res. 2010 Jun;468(6):1498-505. doi: 10.1007/s11999-009-1207-x. PMID: 20094853; PMCID: PMC2865597.
- Sherman SL, Lyman S, Koulouvaris P, Willis A, Marx RG. Risk factors for readmission and revision surgery following rotator cuff repair. Clin Orthop Relat Res. 2008 Mar;466(3):608-13. doi: 10.1007/s11999-008-0116-8. Epub 2008 Feb 10. PMID: 18264848; PMCID: PMC2505218.
At a Glance
Dr. Thomas Obermeyer
- 15+ years of training and experience treating complex shoulder and sports medicine conditions
- Expert subspecialized and board-certified orthopedic care
- Award-winning outstanding patient satisfaction scores
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