23410 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute

Name of the Procedure:

Repair of Ruptured Musculotendinous Cuff (e.g., Rotator Cuff) Open; Acute
Commonly known as Open Rotator Cuff Surgery

Summary

Open Rotator Cuff Surgery involves making an incision in the shoulder to repair a tear in the rotator cuff muscles and tendons. The surgeon reattaches the torn tendon to the bone using sutures and/or anchors.

Purpose

The procedure addresses tears in the rotator cuff, which can cause pain and limit shoulder movement. The goal is to relieve pain, restore shoulder function, and improve the patient's quality of life.

Indications

• Persistent shoulder pain
• Weakness or inability to lift the arm
• Rotator cuff tears confirmed by MRI or ultrasound
• Failure of conservative treatments such as physical therapy or medication

Preparation

• Preoperative fasting (typically from midnight before surgery)
• Adjustment or cessation of certain medications, as advised by the doctor
• Pre-surgery imaging (MRI or ultrasound) to assess the extent of the tear
• Blood tests and physical examination to ensure the patient's fitness for surgery

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made over the shoulder.
3. The surgeon identifies and evaluates the tear.
4. The torn tendon is reattached to the bone using sutures and/or anchors.
5. The incision is closed with sutures or staples.
6. A sterile bandage is applied.

Duration

The procedure typically takes 1.5 to 2 hours.

Setting

Performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Stiffness or loss of motion
• Nerve damage
• Re-tear of the tendon
• Adverse reaction to anesthesia

Benefits

• Relief from shoulder pain
• Improved shoulder strength and function
• Enhanced quality of life Improvement may be observed within a few months, with full benefits typically realized after rehabilitation.

Recovery

• Use of a sling for several weeks to protect the repair
• Pain management with prescribed medications
• Physical therapy starting a few weeks post-surgery
• Full recovery can take 4-6 months, with activity restrictions during this period

Alternatives

• Physical therapy and rehabilitation
• Arthroscopic surgery (a minimally invasive option)
• Corticosteroid injections for temporary pain relief
• Watchful waiting for minor tears

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-surgery, there may be some pain and discomfort, which can be managed with medications. Physical therapy will be crucial for a successful recovery, restoring strength and mobility over time.