Information about Rotator cuff repair
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I think it depends very much on what you mean by 'tendon tear'? If you are young and active and have a very large rotator cuff tear then sugery within six months of injury should be considered. However, if it is a small (or especially partial thickness tear, which really isn't a 'tear' as such) and you are doing well with rehabilitation then I would see how you got on over the next few months, as it may well settle further
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A new ultrasound scan would help in determining if the tendon tear is enlarging, and if associated with inflammation/bursitis & impingement. If physiotherapy, activity modification, and analgesia are ineffective, then subacromial decompressive surgery with the possibility of cuff repair should be considered.
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I presume you are taking about proximal i.e. Rupture at the shoulder rather than elbow - which is generally best repaired. It depends on your level of function i.e. the demands you put on your arm. If retired and sedentary you can expect a bulge in the arm that lessens with time, cramping pain that would diminish over 6 months or so, and the weakness is fairly minimal - the tendon is one of two (hence bi-ceps). If younger and using the arm for sports or manual labour then the weakness may be more of an issue. The tendon cannot be repaired at the shoulder but can be reattached to the tip of the arm so that it effectively works as it did. There's no rush to do so and it could be done in the next couple of months or so. Overall therefore, we rarely do surgery in the early stages, unless it was felt that there would be a problem with weakness. No harm in discussing sooner rather than later with a shoulder surgeon. No harm in discussing
It is indeed a potentially lengthy process! The shoulder is certainly more more pianful and stiff initially, whether it be an open or arthroscopic (keyhole) procedure. Most patients have a sling for a few weeks. I tell patients not to expect any improvement until at least three months, and find that patients get a lot better between the 3 and 6 month mark, still improving (particularly in strength) up to a year. Of course, there are lots of variables including the size of the tear and repair, and everyone is different, but these are general figures. In terms of driving, patients can when they feel safe to, generally after a few weeks. Most patients get good benefit from this surgery, but you are right to give some thought to the aftermath!
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