Frequently Asked Questions - Shoulder Surgery - Dr. Kevin Kruse

Frequently Asked Questions – Shoulder Surgery

Dr Kruse has compiled a list of the most frequently asked questions from patients, and provided extensive answers on these. Below is an abridged version of these questions and answers, please click through via the question or link for the full answer provided by Dr Kruse.

Can an X-Ray show a Torn Rotator Cuff?

An X-ray alone cannot definitively diagnose a torn rotator cuff, as it primarily reveals the shoulder’s bony structures. While it may show signs suggesting a tear, such as a spur on the acromion or wear on the humerus, it lacks detailed insights into soft tissues. For a definitive diagnosis, soft tissue imaging techniques like MRI, ultrasound, or CT Arthrogram are necessary. MRI is the most common method, offering a comprehensive view but requiring a longer session. Ultrasound is quick, comfortable, and equally effective, while CT Arthrogram is an alternative when MRI is unsuitable. Soft tissue imaging is vital for understanding the tear’s specifics and guiding treatment.

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Can you wait too long to have Rotator Cuff Repair Surgery?

Delaying rotator cuff repair surgery can potentially lead to irreversible damage, especially in the case of large tears. Small tears (1 cm with minimal retraction) might be safely observed over time, but large tears (2-3 cm with significant retraction) require more urgent attention. Comparing the rotator cuff to an accordion, if it shortens too much, it may become impossible to extend it back. The decision to undergo surgery should be made with a shoulder surgery specialist, considering the unique nature of each patient and tear. While small tears can be monitored, a significant increase in pain or weakness warrants immediate reevaluation. Delaying surgery, particularly for larger tears, can lead to irreversible fatty atrophy in the muscles, making surgery less effective. It’s crucial for patients to find a balance between avoiding unnecessary surgery and addressing the tear before it worsens irreparably. Patients should seek advice from a specialist who understands the complexities of rotator cuff tears and values patient autonomy in decision-making.

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Can you wear a bra after rotator cuff surgery?

Wearing a bra after rotator cuff surgery is a common concern for many women, but it is indeed possible with the right approach. Contrary to some beliefs, strict arm immobility is not always necessary post-surgery. A practical method for putting on a bra involves starting with the bra unbuckled, fastening it in front, then rotating it around and sliding the arms through the straps. This technique requires some shoulder movement but remains within the safe range recommended after surgery.

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How Long Does Shoulder Surgery Take?

The duration of shoulder surgery, such as rotator cuff repairs, varies depending on several factors. These include the type of surgery, the surgeon’s experience, and the surgical team’s efficiency. While a study in a shoulder journal cited an average duration of about two hours, in some specialized practices, the time can be significantly shorter, sometimes less than 30 minutes. This efficiency is achieved through a combination of the surgeon’s experience, a skilled team, and advanced technology. The goal is to balance quality and speed, ensuring optimal outcomes while minimizing risks associated with longer surgery times. Patients should discuss with their surgeon about the expected duration of their specific procedure and the surgeon’s experience.

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How can you tell if you have torn your Rotator Cuff?

To determine if you have a torn rotator cuff, look for symptoms like pain during shoulder movement, pain at rest, disrupted sleep due to shoulder pain, and difficulty performing routine activities. For diagnosis, a physical exam and imaging tests like X-rays and ultrasound are necessary. Despite common misconceptions, the ability to move the arm doesn’t rule out a tear.

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How long do I have to sleep in a recliner after Shoulder Surgery?

After shoulder surgery, sleeping in a recliner is not a medical necessity; it’s a personal choice. There’s no solid evidence suggesting that it’s required. Instead, it’s recommended to sleep in your bed, using pillows to create a slight incline and support the operated shoulder. This position, akin to a “lazy beach chair,” is often more comfortable and conducive to recovery. Good sleep is crucial for healing, and using pillows for support in bed can provide the necessary comfort, making the recovery process more manageable. (See  also Tips For Sleeping After Shoulder Surgery)

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How long do I have to wait to drive after shoulder surgery?

You can resume driving almost immediately after shoulder surgery, as long as you feel comfortable and safe doing so. It’s important to ensure you’re not taking strong, narcotic pain medication that could impair your ability to drive. Driving typically doesn’t pose a risk to the operated shoulder, as it usually doesn’t require heavy lifting or raising the arm above 90°. Practicing in your neighborhood with someone’s assistance can be a good starting point. The decision to drive should be based on your comfort level and safety, not on a predetermined time frame post-surgery.

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Is Arthroscopic Surgery Worth it?

Arthroscopic surgery for rotator cuff repairs is generally considered worth it, offering benefits like minimal invasiveness, quicker recovery, efficient procedure time, strong repair, enhanced precision due to better visualization, and reduced complications. Its acceptance and effectiveness have grown significantly over the years, making it a preferred choice for many surgeons and patients.

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Rotator Cuff Surgery and using the bathroom?

After rotator cuff surgery, patients can usually use the restroom normally. The use of a sling post-surgery is primarily for comfort and isn’t always a strict necessity. Gentle movements below shoulder level are safe and won’t harm the surgical repair. Surgical repairs are typically robust enough to withstand controlled, gentle movements. Patients should not fear using their arm normally for basic activities like using the restroom, as long as the movements are controlled and gentle. Soreness is expected, but it generally doesn’t prevent the careful use of the arm. It’s important to follow the surgeon’s specific advice, but in most cases, gentle arm use is permissible and safe.

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What Happens if a Rotator Cuff Tear goes Untreated?

Leaving a rotator cuff tear untreated can lead to varying consequences, depending on the tear’s size and severity. Small tears without significant retraction can often be managed with observation and rehabilitation. However, larger tears, especially those showing retraction, might become more difficult to repair if left untreated, potentially leading to less functional recovery.

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