Rotator Cuff Repair Surgeon

Head Sports Medicine Physician Nikhil Verma, MD

Are you an athlete who participates in sports that involve throwing overhead? If so, you may be at risk of developing a rotator cuff injury. The rotator cuff can become damaged from repetitive overuse, a sports injury, a fall or degeneration of one of the tendons. Rotator cuff surgeon, Dr. Nikhil Verma provides diagnosis and both surgical and nonsurgical treatment options for patients in Chicago who have developed a rotator cuff injury. Contact Dr. Verma’s team today!

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(312) 432-2387

Rotator Cuff Repair Overview

The rotator cuff is a system of tendons and muscles located within the shoulder joint. The muscles and tendons connect the upper arm bone (humerus) and the shoulder blade (scapula) to provide stability and assist with movement. The rotator cuff can become injured from sports activities, a fall, repetitive arm movements or degeneration of the rotator cuff tendon. An injury to the rotator cuff can range from mild tendonitis to a complete tear. A surgical rotator cuff repair is typically required in cases that involve a partial or complete tear. Dr. Nikhil Verma, Chicago, Westchester, Oak Brook and Hinsdale, Illinois area shoulder surgeon, offers various rotator cuff repair techniques and aids in rotator cuff repair protocols to get patients back to the sports and activities they love.

A rotator cuff injury can cause sharp pain and tenderness within the shoulder joint. In many cases, an injury can heal with conservative measures such as rest, ice, injections and anti-inflammatory medications. If these measures do not alleviate the pain or if a tear is present, Dr. Verma may recommend a surgical rotator cuff repair followed by a strict guideline of rotator cuff repair protocols. Based on his extensive experience and training, Dr. Verma is able to offer numerous surgical techniques to repair a damaged rotator cuff, including a ‘single row’ arthroscopic rotator cuff repair, ‘double row’ arthroscopic rotator cuff repair, patch augmentation rotator cuff repair, complex rotator cuff repair and revision arthroscopic rotator cuff repair.

PATIENTS WITHOUT INSURANCE

Dr. Verma participates in the MOR Package Pricing program for Rotator Cuff Repair

Rotator Cuff Repair Procedure Cost: $11,300

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‘Single Row’ Arthroscopic Rotator Cuff Repair and ‘Double Row’ Arthroscopic Rotator Cuff Repair

Patients who have experienced a more severe injury, such as a complete tear, to the rotator cuff may be a candidate for a ‘single row’ arthroscopic rotator cuff repair or a ‘double row’ arthroscopic rotator cuff repair. A ‘single row’ or ‘double row’ refers to the way the tendons are repaired during surgery, either by a single or double row of sutures. Both techniques utilize an arthroscopic approach to help patients return to activities quicker with less pain during recovery.

Patch Augmentation Rotator Cuff Repair

A patch augmentation rotator cuff repair is an effective and safe surgical technique used to provide strength and a positive healing environment for the tendon. After the damaged tendon is repaired arthroscopically, Dr. Verma will determine if an augmentation will benefit the tendon. If so, a graft (patch) is made from cadaveric dermis (human collagen from skin) and then sewn into the rotator cuff tendon. A repair is then made by the use of strong sutures and anchors into the bone to secure the tendon and graft in place. The concept is similar to repair a hole in your jeans and then placing a patch over the top to provide strength to the repair. The patch provides both improved mechanical strength, and the presence of collagen and other growth factors improves the biologic environment for healing.

Complex Rotator Cuff Repair

If the rotator cuff tear is too large or complex or if additional reconstruction has to be performed, such as a tendon transfer, Dr. Verma may recommend an open surgery technique. In this technique, Dr. Verma will make an incision over the shoulder and detach the deltoid muscle to gain access and visibility to the torn tendon. If needed, he will also be able to remove any bone spurs or other structures from the underside of the acromion. In this situation, an alternate tendon is transferred to attach to the humerus and substitute for the torn rotator cuff and help improve function and decrease pain. Commonly used tendons include the latissiums and the pectoralis major.

Revision Arthroscopic Rotator Cuff Repair

If a patient had a rotator cuff repair that hasn’t healed correctly, or has re-torn following surgery, a revision arthroscopic rotator cuff repair may be recommended by Dr. Verma. The exact revision surgery varies from patient to patient depending on original rotator cuff repair treatment and multiple factors such as size of the recurrent tear, quality of the remaining muscle and tendon, and age and functional demands of the patient.  Options for treatment including repeat repair of the tendon using a double row technique, augmenting the repair with a patch and substituting for the re-torn tendon using a tendon transfer, implant or allograft (donor) tissue. In many cases, a patient can expect pain relief, increased shoulder function and a high success rate of the revision surgery if proper rotator cuff repair protocols are followed.

Rotator Cuff Repair Protocols

Dr. Verma will provide a detailed guideline for all patients to follow after their revision rotator cuff repair. Each patient will have a unique set of rotator cuff repair protocols based on the original injury and surgical procedure. All patients can expect to wear a sling for several weeks to keep the arm immobilized.

Physical therapy is a critical component in the recovery process. It is extremely important that patients follow the advice of Dr. Verma and the physical therapy team so the rotator cuff repair is not compromised. Typical physical therapy involves a passive range of motion, active range of motion, strengthening exercises and maximum recovery is expected at approximately one year following the procedure.

Rotator Cuff Stem Cell Trial Patient Story

Rotator Cuff Repair FAQ

How do I know if I have damaged my rotator cuff?

Often when a rotator cuff is damaged or torn, it is caused from a fall or injury but can also be caused by normal age-related wear and tear. Pain in the front of the shoulder that radiates down the side of the arm can be an Indication that the rotator cuff is damaged. Overhead activities, such as throwing or lifting and reaching may make the pain worse.

A damaged rotator cuff can also cause weakness in the arm along with difficulties with simple routine activities, such as reaching behind the back or combing one’s hair. Nighttime pain or pain that disrupts sleep is also an indication of a damaged rotator cuff.

How painful is a torn rotator cuff?

Sudden tears of the rotator cuff that occur from an acute injury can cause immediate, intense pain with a snapping sensation and immediate weakness in the arm. However, rotator cuff tears that occur over time from wear and tear or slow degeneration of the tendon do not have sudden symptoms. Instead, symptoms from a gradual tear can include:

  • Pain at night while resting, especially if lying on the shoulder
  • Pain when lifting and lowering the arm through specific movements
  • Weakness when lifting or rotating the arm
  • Cracking, popping in the shoulder when moving or in certain positions

Do rotator cuff tears heal on their own?

Many partial thickness rotator cuff tears and even some full thickness tears may be treated without surgery. Non-surgical treatments include ice, rest, activity modification, non-steroidal anti-inflammatory medications, steroid injections and physical therapy. Large, full thickness rotator cuff tears have been shown to get larger over time and do not heal on their own. Dr. Verma suggests surgical intervention for large rotator cuff tears to restore function, reduce pain and to prevent the tear from becoming bigger.

Is rotator cuff surgery considered major surgery?

Most rotator cuff surgeries are done on an out-patient basis but are still considered “major” surgery. Dr. Verma will discuss the associated risks and recommended post-operative protocol for this patients needing rotator cuff surgery.

How long does it take to recover from torn rotator cuff surgery?

Recovery time will vary based on the extent of tendon damage, age and health of the patient and actual shoulder surgery performed. Typical tears can take six months to reach full recovery.

How do I relieve rotator cuff pain?

The painful symptoms of a rotator cuff tear can be treated with ice, placed at the front of the shoulder, where the pain is felt. Rest and discontinuation of the activities that cause further shoulder pain will also help. Dr. Verma may prescribe non-steroidal anti-inflammatory medication (NSAIDs) or administer a steroid shot into the shoulder which can also relieve pain.

What is the average recovery time for rotator cuff repair surgery?

The surgery for a torn rotator cuff without other conditions or shoulder damage can take an average of 1-2 hours. Patients are often kept in the recovery room for several hours so they can be monitored. Once a patient is comfortable and alert, Dr. Verma will release them to go home, with a follow-up visit in his office several days afterward.

Will a cortisone shot help a torn rotator cuff?

Studies have shown that cortisone injections can be incredibly helpful at limiting the acute inflammation of in the setting of rotator cuff pathology and allowing the patient to begin therapy. Dr. Verma considerer many factors which influence the decision as to whether surgery is recommended vs. an injection of cortisone. He will discuss these with you after the diagnosis is made.

It is important to follow Dr. Verma’s physical therapy recommendations, even if the shoulder feels better after an injection. While the cortisone can help keep shoulder inflammation down, physical therapy will help prevent a recurrence of symptoms.

For additional information on rotator cuff injuries, or to learn more about the various rotator cuff repair techniques, please contact the office of Dr. Nikhil Verma, orthopedic shoulder surgeon serving the communities of Chicago, Westchester, Oak Brook and Hinsdale, Illinois.

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