Arthroscopic rotator cuff repairs cause minimal trauma to the tissues that surround the shoulder and the rotator cuff. This leads to patients having smaller scars and less damage to these nearby structures. Most important of these surrounding structures is the large deltoid muscle over the outside of the shoulder. One potential complication of an open rotator cuff repair is detachment of the deltoid. This potential problem is avoided by the arthroscopic technique. Some surgeons also believe they can see the rotator cuff much better through an arthroscope, and can maneuver throughout the shoulder joint without the limitations of an incision.
It is important to remember that successful surgery invariably depends on a good partnership between the experienced surgeon and the patient. Patients should always try to optimize their overall health in order to be in the best possible condition for this procedure. Ideally, patients who smoke should stop at least one month prior to surgery and not resume for a minimum of three months afterward. Any lung, kidney, heart, bladder, tooth, or gum problems should be dealt with before surgery. Even the smallest infection may be reason enough to delay the operation. Some surgeons may ask that you scrub with a special soap, such as Phisohex before surgery. The specifics of which soap and the method of use should be discussed with your surgeon. Importantly, the surgeon needs to be aware of all significant health issues, especially known allergies and the prescription and nonprescription medications being taken, as some of these medications might have to be modified or stopped completely. This is true for medications such as aspirin and anti-inflammatory drugs which may affect the way blood clots. Since blood transfusions may be called for, patients may select to have a blood bank draw and store the patient’s own blood for a possible auto-transfusion. In addition, surgical procedures for elbow arthritis may be delayed until the time that is best for the patient’s well-being. However, in cases involving rheumatoid arthritis or other types of inflammatory arthritis, excessive delays may result in the loss of tendon tissue and bone. These losses may compromise the quality of the surgery as well as its result.
Prior to surgery, patients should always consider the alternatives, limitations, and risks of surgery. Patients should also recognize that the result of any surgery largely depends on their efforts in rehabilitation after surgery.
The patient should plan on being less functional for a period approximately six to twelve weeks after the operation. Shopping, driving, or performing normal work or chores may be difficult during this time. Plans for assistance should be arranged prior to surgery. For those individuals who live alone or are without readily-available help, arrangements for home care should be made well in advance.