the rotator cuff is the tendon that helps us lift our arm occasionally the rotator cuff
can be damaged and rotator cuff is either damaged with an acute injury or a trauma or with chronic
attritional degenerative changes if a rotator cuff is injured or torn we usually use imaging
modalities such as an MRI to document if the tenon is torn depending on the severity of the
tear as well as the age and the activity level the individual that person may or may not need
surgery sometimes we can rehabilitate patients with physical therapy and occasionally cortisone
injections if individuals don't improve with conservative care or they have a large tear
oftentimes we will recommend surgical intervention foreign rotator cuff before the surgery our job is
give patients the adequate and appropriate amount of information to understand exactly what's gonna
happen that day so the pre-admission testing team is an excellent support staff that we are
fortunate to have at Northwestern once we've received notification from the surgeons office
we contact the patient to set up any testing that needs to be done this would include things like
chest x-rays lab work and EKGs the patient is called the night before to be notified
what time their surgery is and what time they need to arrive at the hospital patients having
shoulder surgery will need to wear something loose preferably button-up that is easy to put
on after surgery on the day of the surgery the patient checks in at the front counter it meets
the staff there the patient will be seen by a surgeon who will be performing the surgery will
discuss the procedure as well as confirm that the informed consent form that the patient will sign
matches with the correct extremity after this the anesthesiologist will discuss choices and
options for anesthesia typically for shoulder surgery there are two types of anesthetics a
patient will receive the first component is a general anesthetic and a second component the
anesthetic is a nerve block typically for shoulder surgery there is a specific block
that is used to help take away pain from the shoulder after surgery nerve block serves two
purposes first it can control pain before and after the operation it usually allows patients
to go home feeling limited to no pain because the anesthetic works for approximately 12 to 18 hours
the less pain the patient is experiencing during the operation requires less general anesthesia
so when patients wake up from the operation the oftentimes go home not feeling nauseated nerve
blocks are safe which is why it's a routine one of our hands TEDx for patient undergoing
shoulder surgery in the operating room usually there are three or four people first there is
the anesthesiologist second there's myself and often times my physician assistant there will be
a scrub nurse whose job is to pass instruments to myself and my physician assistant during the
operation thankfully with modern technology we can do arthas copic repairs of rotator cuff tears no
longer do we need to use open incisions to a repair a rotator cuff arthas copic surgery is
essentially an arthroscopic minimally invasive modality using small incisions and a camera that
allows us to take the torn tendon and reattach it to the bone patients wake up in the operating room
a lot of times because of the anesthetic they won't remember that the patient is transported
from the surgical suite to the recovery room at which time a surgical post-operative nurse will
take care of them after rotator cuff surgery patients can remove their dressing after two
days they can apply band-aids and shower after a rotator cuff surgery in individuals in a sling
for approximately four weeks the sling is to be utilized when individuals sleep and when
they're up and walking around when individuals are sitting down they can bend their elbow they
can take their sling off patients can return to driving once they are off pain medications and
they feel safe to drive they just need to remove their sling patients will be restricted to one arm
after surgery for a while so may need help with chores and food preparation immediately after
surgery it's important to get things set up at home it's important to have family members help
if possible thinking about these things before the operation will typically make the surgical
experience a lot better after about six weeks we start using our arm above our chest level to about
the forehead or eye level after about eight weeks we start utilizing our arm above our head or above
our shoulders and that's supervised under the guidance of physical therapy physical therapy
and occupational therapy is extremely valuable postoperatively to allow and offer an opportunity
for the joint to return to its pre injured State for a rotator cuff it can take anywhere between
four to six months of really rehabbing to get that shoulder back to working well again the
role of the patient is really important as far as rehab goes they really have to buy into the whole
process and understand that we're really trying to work towards getting them back to where they were
prior to surgery home exercises for the patient is one the more important aspects of recovery my
advice for the home exercise is to try to really get into a routine we aim to advance individuals
along a guided physical therapy program over the course of the first three to four
months to achieve their full function recovery most individuals reach their maximum medical
improvement somewhere between four to six months after the procedure we take measures through
anesthesia through preoperative physical therapy through post-op or physical therapy as well as
surgical technique to perform the procedure in the least invasive measure when you come to
northwestern you're receiving the most innovative cutting-edge procedure that is available