Rotator Cuff Repair vs. Shoulder Replacement

Both rotator cuff repair and shoulder replacement surgery are excellent operations for patients with shoulder pain. Which operation you need is dependent on what the cause of your shoulder pain is and what treatments you have had in the past.  Here is a breakdown of each.

Rotator cuff repair: This operation is minimally invasive and can be done through several poke holes around the shoulder.  It fixes the tendons of the shoulder that keep the ball of the shoulder centered on the socket throughout range of motion.  When they tear, the shoulder does not move or function properly, which causes numerous other problems in the shoulder that result in shoulder pain, aching and throbbing at night, weakness, and difficulty reaching overhead.  Rotator cuff repair surgery generally has very good results, but there is a prolonged course of immobilization of the shoulder and physical therapy that is usually necessary afterwards.  The reason for the prolonged rehab is because you are relying on the tendons to heal back down to bone which is a process that can take months.  Overly aggressive motion or lifting after surgery can cause the tendon to retear, negating the benefits of the surgery.

Shoulder Replacement: Shoulder replacement surgery on the other hand, is a more significant operation requiring a larger incision and generally more invasive.  This operation is most appropriate for patients with advanced arthritis of the shoulder, or patients who have had multiple rotator cuff surgeries in the past that have failed. Despite being more invasive, the rehab and recovery is actually much easier and faster than rotator cuff repair surgery. This is because we are less reliant on the soft tissue structures around the shoulder after a replacement. Very often, patients come out of the sling after a few weeks and can start using the shoulder for daily activities. Also, pain relief and satisfaction after shoulder replacement surgery comes much faster than with rotator cuff repair surgery.

Bottom line: Both rotator cuff repair and shoulder replacement surgeries are extremely effective at addressing shoulder pain and dysfunction. However, which one you need is dependent on your unique situation.  Call or visit us online to set up a consultation to discuss if shoulder surgery is right for you, and if so, which option suits your needs best.

Author
William Ashford, MD

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