The rotator cuff is the term for a group of muscles around the shoulder. Due to its position and the actions it is required to carry out, the rotator cuff is prone to injury or wear. While rotator cuff damage can frequently be managed conservatively, surgical repair may also be an option. According to the American Academy of Orthopedic Surgeons, "the overall complication rate following rotator cuff repair surgery is estimated to be approximately 10 percent." These potential complications include infection, damage to muscles and nerves, decreased mobility of the shoulder, chronic pain and re-tearing of the rotator cuff.
Infection
Concern about surgical site infection isn't confined to rotator cuff repairs. According to 2009 information from the Centers for Disease Control and Prevention, infections occur in about 290,000 of the 27 million surgeries performed in the United States each year. For orthopedic surgeries, including rotator cuff repairs, the rate is less than 1 percent. Signs of an infection are swelling, warmth and redness, possibly pain or drainage around the incision site, and fever. The AAOS states that antibiotics given during surgery have proved to be the most effective way to reduce the incidence of infections with these surgeries.
Damage to Muscles and Nerves
The shoulder hosts a complex array of muscles and tendons, bones and nerves. According to a 2008 "New England Journal of Medicine" article posted on the University of Washington's Department of Orthopedic and Sports Medicine website, the deltoid muscle, the axillary nerve and the bones and ligaments of the coracoacromial arch are all at risk for damage during a rotator cuff repair. The AAOS states that about 1 to 2 percent of those having rotator cuff surgery will end up with damage to the axillary nerve, while less than 1 percent will end up with a detached deltoid muscle.
Loss of Range of Motion
Damage to the nerves and muscles, sutures, and roughness of the bony surfaces following a rotator cuff surgery, along with the ubiquitous pain, can lead to loss of range of motion of the shoulder following rotator cuff surgery. Even if the surgery is successful without any other complications, some people find it challenging to do the exercises prescribed by a physician or physical therapist, because they can be painful. However, initiating shoulder rehabilitation, as soon as possible, has kept the incidence of stiffening of the rotator cuff after surgery to less than 1 percent, according to the AAOS.
Re-tearing of the Rotator Cuff Tendon
The AAOS reports that the rotator cuff tendon ends up being torn again in about 6 percent of rotator cuff repairs. According to the "New England Journal of Medicine" article, if the original tear occurred after only a minor trauma, the tendon is more at risk for re-tearing after surgery. The article goes on to recommend a three- to six-month period of protecting the repaired tendon from falls and excessive use to allow for more thorough healing.
References
- American Academy of Orthopedic Surgeons: Rotator Cuff Tears and Treatment Options
- University of Washington Department of Orthopaedics and Sports Medicine: Repair of Rotator Cuff
- University of Washington Department of Orthopaedics and Sports Medicine: New England Journal of Medicine article on Rotator-Cuff Failure
- Centers for Disease Control: Surgical Site Infection FAQ
