Patients undergoing rotator cuff surgery are typically quite anxious about what to expect on the day of the procedure. While every rotator cuff operation is slightly different, and there is some variability among surgeon protocols, the same basic principles apply.
The majority of rotator cuff repairs are now performed in a minimally invasive fashion - arthroscopically. Patients arrive at the hospital or surgery center on the day of the procedure, typically 1-2 hours before the scheduled time. The pre-operative nurses will place an IV line in the opposite arm and wash the operative site with a special anti-bacterial soap.
You will meet the anesthesia team and often receive an injection, or “nerve block” while still in the pre-op area. This is designed to minimize your discomfort for the first 24 hours following the procedure. It will also allow for a lesser amount of pain medication needed during the surgery and consequently, possibly less post-op nausea. Your surgeon will also see you in the pre-op area to answer any last-minute questions and to verify the procedure to be performed. Your surgeon will also write his or her initials on your shoulder with a marker.
Once in the operating room, you will be given antibiotics through the IV along with the anesthesia medicine. Most rotator cuff surgeries are performed using general anesthesia. The length of the operation can vary greatly depending on the size of the rotator cuff tear and quality of tissue itself. The surgeon will sew the torn rotator cuff tendon back to the bone.
You will awake from anesthesia while still in the operating room, although due to the effects of the anesthesia medications, most patients are still groggy for at least another 20-30 minutes. Before leaving the operating room, your surgeon will place the operative arm in a protective sling.
Most patients remain in the postoperative recovery area for approximately one hour, although this may vary greatly depending on patient age and other medical problems. Before leaving, the recovery room nurse will be sure that your pain is adequately controlled. The nurse will also review the surgeon’s post-operative instructions and answer any questions. They will also verify that a prescription for pain medicine has been provided.
Once at home, rest as much as possible, and ice the shoulder frequently for 20 minute intervals. Begin eating by having a light snack, and advance your diet as tolerated. Start taking oral pain medicine as needed. Most importantly, if you have any concerns or questions, call you surgeon’s office immediately!