Expectations Following Rotator Cuff Surgery

Abstract

Purpose of Review To outline the radiographic and clinical outcomes after a rotator cuff surgery in order to set the expectations with the patient before the surgery to obtain a better outcome, taking into account the factors that can affect the outcome and the technique used for the repair. Recent Findings The majority of surgeons use arthroscopic repair.The double-row repair has better biomechanical strength, footprint coverage, and radiographic healing rates. The principal factors that can affect the outcome of the surgery are the tendon quality, tear size and retraction, fatty infiltration, chronicity of the tear, and concomitant pathologies. Summary Arthroscopic rotator cuff repair can decrease pain and increase function allowing patients to improve their quality of life; 90% of patients are happy 6 months after the surgery and maintain stability during 5 years. Greater preoperative expectations would show better outcomes and patient satisfaction after the surgery.

The UCLA Shoulder Score Is a Better Predictor of Treatment Success Than the Constant and Oxford Shoulder Scores After Arthroscopic Rotator Cuff Repair: A 2-Year Follow-Up Study

“…Hence, they are more likely to be satisfied and have had their expectations met after the surgery. 31 This supports current recommendations that a nonoperative approach should be the first-line management for all patients with small cuff tears and mild preoperative symptoms. 32,33 Arthroscopic rotator cuff repair should be recommended when conservative treatment fails or in patients with larger tears and more severe preoperative functional impairment, to increase the odds of treatment success.…”

Imaging of traumatic shoulder injuries – Understanding the surgeon’s perspective

“…Surgical repair of RCTs generally have good outcomes, with US showing a healed rotator cuff tendon in 64% of patients at one year postoperatively, up to 75% at two years, and 81% at five years, as well as restoring function [55] , [56] . The rate of complication after arthroscopy is approximately 11% [57] , and the most common cause of failure is poor healing of repaired tissue, leading to suture pull out ( Fig.…”

Perioperative anaesthetic considerations for rotator cuff repair surgeries: A current concept review

“…Post-operative pain associated with RCR surgery may cause prolonged in-hospital stay or re-admission and affect rehabilitation. 7,38 The PROSPECT (PROcedure-SPECific post-operative pain managemenT) guideline (under European Society of Regional Anaesthesia and Pain therapy)provides evidence-based practical recommendations for perioperative pain management for potentially painful operations, including Rotator cuff repair surgeries. 39 They guidelines evaluated a total of 59 randomised controlled trials and one systematic review to evaluate the effects of analgesic and surgical interventions on postoperative pain after RCR surgery, and the following recommendation was made.…”

“…A thorough pre-operative assessment, strategic anaesthetic planning including monitoring, analgesia and timely identification of complications and its management is crucial. 5,7 This review provides an overview of various peri-operative anaesthetic management strategies of patients undergoing RC repair surgeries. We highlight the anaesthetic approach as well as various pharmacologic pain interventions to improve safety and surgical outcome.…”