Treatment Options

Surgical Treatment for a Rotator Cuff Tear

Moderate Value

Surgery is often considered the first treatment option for rotator cuff tears that limit a person's ability to  function, turn the arm outwardly against resistance, or raise the arm. Surgery is considered the second treatment option for partial tears when other types of treatment have not worked. It is also considered when a person experiences increased loss of function or continued pain, spasms and limited motion. The goal of surgery is to get the tendon to heal to the bone. Several types of surgery can be used for rotator cuff repair. Surgeons choose the type of surgery depending on their experience and knowledge. They also consider a person's anatomy, specific needs and the quality of the tendon and bone.

Three common types of surgery include open repair, mini-open repair, and all types of arthroscopic repair. Open repair involves an incision over the shoulder. A mini-open repair involves the insertion of an instrument called an arthroscope, which allows the surgeon to see the area and the tear, and makes it easier to remove bone spurs if necessary. A mini incision is then made to repair the rotator cuff. Arthroscopic repair involves smaller incisions and the insertion of an arthroscope to look at and repair the rotator cuff. After surgery the doctor will provide an exercise program to help strengthen and move the shoulder.

Talk with your doctor to determine the best treatment option for you. If surgery is recommended discuss which is the best type for you.

Things to Consider

  • “Rotator cuff” is the term used for muscles and tendons in the shoulder that help lift and rotate the arm, and keep the shoulder in place.
  • Rotator cuff tears are more likely to occur in the shoulder that is used the most.
  • For young people, rotator cuff tears occur with activities such as accidents, sports, and working overhead with a repetitive motion.
  • The chances of having a rotator cuff tear increases as you age.
  • A rotator cuff tear may or may not cause pain or impair the use of your shoulder.

Results

Moderate Value

Will I live longer if I have this procedure?

No, there is no scientific evidence that you will live longer if you have surgery for a rotator cuff tear. A rotator cuff tear is not considered a life threatening condition.

Will the surgical treatment of a rotator cuff tear improve my quality of life?

Yes, treatment of a rotator cuff tear should improve the quality of your life. You should be able to participate in your normal daily activities. The degree of improvement you experience will depend on various factors, such as the extent of the injury, your age and the effort used to rehabilitate and follow activity restrictions.

Does the surgical treatment of a rotator cuff tear make my symptoms better?

Yes, the majority of people who have surgery to repair a rotator cuff tear experience pain relief, improved function and movement. However, full strength may not return. For most people, a significant rehabilitation effort is necessary. The results of rehabilitation depend on your active participation. People unhappy with the results of surgery often had large or massive tears, had poor quality of tissue, failed to comply with prescribed rehabilitation and activity restrictions, and were typically older.

Safety

Significant Value

Each type of surgery provides similar pain relief, improved strength and satisfaction. About 90 percent of surgical rotator cuff repairs result in no complications. However, the open repair leads to more pain, stiffness, loss of blood, and longer recovery than the less invasive procedures.

Minor reported complications:

  • Stiffness
  • Loss of motion
  • Infection

Major reported complications:

  • Nerve damage
  • Tendon re-tear
  • Muscle detachment

Comparison

Intermediate Value

Alternative treatment (behavioral modification) includes:

  • Resting and avoiding activities that cause pain or weakness
  • Wearing a sling
  • Taking anti-inflammatory medications
  • Strengthening exercise and physical therapy
  • Taking steroid injections
  • The potential benefit of trying alternative treatment is eliminating the need for surgery and its risks.
  • The potential drawbacks of trying alternative treatment are that strength may not improve, the tear may increase in size, and the ability to perform activities may be limited.

Cost

Moderate Value

The cost of surgical repair for a rotator cuff tears varies depending on a number of factors including the type of surgery, type of facility, type of care you need, and the region of the country in which the surgery is performed. The costs can vary from approximately $300 to $15,000 for the hospital costs plus $225 to $ 4,750 for the physician costs.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

American Academy of Orthopaedic Surgeons. (2011, May). Rotator cuff tears. Retrieved August 14, 2013 from http://orthoinfo.aaos.org/topic.cfm?topic=A00064&return_link=0.

American Academy of Orthopaedic Surgeons. (2011, May). Rotator cuff tears: Surgical treatment options. Retrieved August 14, 2013 from http://orthoinfo.aaos.org/topic.cfm?topic=A00406&return_link=0.

Mayo Clinic. (2010, August). Rotator cuff injury. Retrieved August 14, 2013 from http://www.mayoclinic.com/health/rotator-cuff-injury/DS00192.

Next Review Date

8/22/2014

This document has been classified as public information.

Table of Findings

results:  moderate value

safety:  significant value

comparison:  intermediate value

cost: moderate value


total: moderate value

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Page modified:November 12, 2012