The rotator cuff is a collection of tendons and four small muscles that surround the bones within the shoulder. Injury or overuse of the rotator cuff can lead to a cuff tear that causes significant shoulder pain and limited arm mobility. Treatment of a rotator cuff tear may involve surgery, depending upon the extent of the tear. Certain people should not undergo this type of surgery. Patients should discuss the contraindications of rotator cuff tear surgery with a doctor when reviewing treatment options.
Stiffness or Arthropathy
Patients who have pronounced shoulder stiffness or arthropathy should not undergo rotator cuff tear surgery until this complication is resolved, Procedures Consult reports. Patients with preoperative stiffness are at an increased risk of developing severe shoulder joint stiffness after surgery.
Elderly Patients Without Pain
Rotator cuff tear surgery should not be performed on elderly patients who do not experience significant pain, Peter M. Parten and Stephen S. Burkhart explain in an article published in the book "Shoulder Arthroscopy." Older patients have a more difficult time recovering from rotator cuff tear surgery than younger patients and are at an increased risk of experiencing surgical complications, such as blood clots or infection. Other forms of rotator cuff tear treatment, such as physical therapy, should be utilized in elderly patients who do not have severe or activity-limiting pain symptoms.
Muscle Atrophy or Tendon Retraction
Patients who have extensive shoulder muscle atrophy or tendon retraction following a rotator cuff tear should not be treated surgically, Drs. Ammar Anbari and Anthony A. Romeo report in an article published in "Surgical Techniques of the Rotator Cuff." Extensive damage to the shoulder joint due to a rotator cuff tear can significantly limit a surgeon's ability to restore and repair the torn muscle.
Severe Illness or Infection
If a patient has an active infection or severe illness unrelated to anesthesia, rotator cuff tear surgery should not be performed, warn Anbari and Romeo. Illness or infection can interfere with a patient's ability to heal from rotator cuff tear surgery and can increase his risk of developing surgical complications, such as infection.
References
- Procedures Consult: Surgical and Medical Procedures - Open Rotator Cuff Repair - Contraindications
- "Shoulder Arthroscopy;" Arthroscopic Repair of Full-Thickness Tears of the Rotator Cuff; Peter M. Parten and Stephen S. Burkhard; 2003
- "Surgical Techniques of the Rotator Cuff;" Arthroscopic Subscapularis Repair; Dr. Ammar Anbari and Dr. Anthony A. Romeo; 2007
- American Academy of Orthopaedic Surgeons: Rotator Cuff Tears
