What Is a Traditional Open Repair of the Rotator Cuff?

A traditional open repair of the rotator cuff is one of the established surgical techniques used to treat significant tears or damage to the rotator cuff tendons. The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, providing stability and allowing for a wide range of shoulder movements. When one or more of these tendons are torn—either from injury, overuse, or age-related wear—a surgical repair may be necessary to restore shoulder function and reduce pain.

What Does a Traditional Open Repair Involve?

In a traditional open rotator cuff repair, the surgeon makes a larger incision, typically about 2 to 4 inches, over the shoulder to fully access the rotator cuff tendons and the surrounding structures. Unlike minimally invasive arthroscopic techniques that use small incisions and a camera to guide the surgery, open repair allows the surgeon to directly visualize and work on the affected tendons.

Once the incision is made, the surgeon carefully moves the surrounding muscles and tissues to expose the torn tendon. Any damaged or frayed tissue is cleaned up, and the torn edges of the tendon are reattached to the bone using stitches or special anchors. In some cases, the surgeon may also remove bone spurs or perform additional procedures to improve the shoulder’s overall stability and function.

When Is Open Repair Recommended?

While minimally invasive arthroscopic techniques have become increasingly popular due to shorter recovery times and smaller incisions, there are situations where a traditional open repair is preferred or necessary. Open repair is typically recommended in cases of:

• Large or complex tears: When the rotator cuff tear is extensive or involves multiple tendons.
• Chronic tears: Tears that have been present for a long time and may have caused muscle retraction or significant tendon degeneration.
• Failed previous surgeries: If an earlier attempt at arthroscopic repair was unsuccessful.
• Associated shoulder conditions: Cases where additional procedures, such as tendon transfers or bone work, need to be done simultaneously.

Benefits and Considerations

One of the key advantages of traditional open repair is that it allows the surgeon a clear, unobstructed view of the rotator cuff and surrounding tissues. This can be particularly beneficial when dealing with complicated cases. However, because open repair involves a larger incision and more muscle dissection, recovery may take longer compared to arthroscopic surgery, and there may be a slightly higher risk of post-operative stiffness.

Recovery After Open Rotator Cuff Repair

Recovery following traditional open repair typically involves several months of rehabilitation. Initially, the shoulder is immobilized with a sling for 4 to 6 weeks to allow proper healing. Physical therapy begins gradually, focusing first on restoring range of motion and then building strength. Full recovery can take anywhere from 4 to 6 months, depending on the size of the tear and the patient’s overall health.

Traditional open repair of the rotator cuff remains a reliable and effective surgical option, especially for patients with large, complex, or chronic rotator cuff tears. While it involves a larger incision and a longer recovery time compared to minimally invasive options, it provides surgeons with the ability to directly address complicated issues and deliver lasting results. Consulting with an orthopedic specialist can help determine whether open repair is the right approach based on the specific nature of the injury.