Whenever there’s a chance to avoid surgery, it’s a great objective to pursue. In the world of rotator cuff tears, which send about 2 million people to seek medical care each year in the United States, going the nonsurgical route can be successful, but not always.
This explains why more than 250,000 surgical rotator cuff repairs are performed each year in the US, and the good news is that these surgeries boast an impressive success rate.
As a leading shoulder specialist in New York City, board-certified orthopaedic surgeon Dr. William Schell has in-depth experience repairing rotator cuff tears through surgery. In the following, we look at why people opt for surgery, and *spoiler alert* — it's usually because conservative efforts have failed.
Your rotator cuff is a group of four muscles that come together to form tendons, which are connective tissues that attach bone to muscle. In the case of your rotator cuff, the tendons cover the head of your humerus (upper arm bone) and attach to your shoulder blade, which allows you to lift and rotate your arm.
Rotator cuff tears are incredibly common — between 10% and 15% of people between the ages of 50 and 59 have rotator cuff tears, and this percentage jumps to half of people 80 and older.
In most cases, orthopedic specialists (and we include ourselves) first recommend conservative treatment, which includes:
And these measures can be quite successful — in about 80% to 85% of cases, nonsurgical treatments work well.
Now let’s look at when they don’t.
There are several reasons why a quarter million (or more) rotator cuff repair surgeries are performed each year, and pain tops this list.
If you’ve diligently followed a conservative treatment path for 6-12 months, but you’re still experiencing debilitating shoulder pain, this is a clear sign that we should get more aggressive in repairing these tissues. Ongoing pain implies that your body isn’t able to repair the tendon on its own, which is where we can step in.
Another reason people opt for rotator cuff surgery is participation in activities that require a strong shoulder. So, whether you’re a house painter or an avid golfer, you want your shoulder to be at peak strength, and surgery can often be the faster route there.
If you have a full tear or a tear that measures more than 3 centimeters, your body can struggle to repair this level of damage. In these cases, surgical repair of the rotator cuff can make good sense.
Going a step further, if your rotator cuff tear is large and developed on the heels of an acute injury (as opposed to gradual wear-and-tear), surgery is often a good path forward.
Ultimately, only you can make the decision to undergo surgery. Our goal here is to outline a few reasons why people opt for rotator cuff surgery after trying conservative treatments.
Of course, we can provide you with invaluable guidance in your decision-making, especially after an extensive evaluation of your rotator cuff tear. To access this guidance, we invite you to contact us at our office on Columbus Circle on the Upper West Side by calling 646-381-2646. You can also contact us by clicking here.
