The double row arthroscopic procedure is a newer technique in arthroscopic surgery and has become increasingly popular due to improved instruments, surgeon skill and comfort level. Dr. Millett performs the double row arthroscopic surgery on patients who have a more severe rotator cuff injury or when this type of repair is needed to provide extra stability for their specific tear.
This technique uses minimally-invasive, keyhole surgery to repair torn rotator cuff tendons. Arthroscopic rotator cuff repair is not only less invasive, but also decreases the risks of post-operative complications such as muscle injury, stiffness, or infection. Double-row repair refers to an anatomic restoration of the original rotator cuff 'footprint' (the exact size, shape and makeup of the rotator cuff). A single-row arthroscopic rotator cuff repair surgery, while effective for many patients, does not re-establish the normal footprint anatomy. The double-row technique uses keyhole surgery to repair the tendons to their natural anatomy using a double-row of sutures rather than just a single row.
While more technically challenging for the surgeon, 'double row' creates a more secure repair and is less painful for the patient who will have an overall better potential for healing of the torn tendons.
The rotator cuff tendon repair needs 4-6 weeks to heal so active motion of the shoulder is not permitted during this time. Physical therapy will usually begin after your first visit to us and will consist of passive motion performed by the therapist. In some cases we will allow you to use water therapy where your arm will be weightless. You will need to wear your sling for 4-6 weeks. After this period you will begin a program of active motion and eventually strengthening. Below is a checklist of what to expect.
- It is normal to have swelling, discomfort and pain in the shoulder area following rotator cuff surgery for a week or more. Apply ice bags or use the icing machine you were given to control swelling. Ice should be applied 20-30 minutes at a time, every hour or so. It helps to put a thin towel or T-shirt next to your skin if using ice in a plastic bag. Icing is most important in the first 48 hours, although many people find that continuing it lessens their post-operative pain.
- If you had a nerve block during surgery, the local anesthetic may keep your shoulder numb for several hours. You will be given a prescription for powerful pain medication when you are discharged from the hospital. If you find you do not tolerate it well, call our office and we will try another one. Many patients find that lying down accentuates their discomfort. You might sleep better in a recliner, or propped up in bed. A pillow placed behind your elbow may also help.
- In the days following your double row arthroscopic surgery, please keep the post-operative dressing clean and dry. Unless it becomes wet or too tight because of swelling, leave the bandages in place for at least 2 days. REMOVE YOUR BANDAGES 2 days after your surgery. Cover your incisions with Band-Aids to keep from snagging the sutures on clothes. You may shower then, but try to keep the incisions dry for the first 10-14 days. Do not wet your incisions directly (bathing or swimming) until at least 2 weeks post-op.
- The sutures are absorbable and do not need to be removed.
- After surgery, we would like to see you back in the office within 10-14 days. If you don't have your first post-operative visit scheduled, call our office to make one.
- Start your shoulder post-operative rehabilitation/physical therapy right away. Your physical therapy program is key to a successful outcome. It should be started the day after surgery. A separate prescription will outline the protocol. It often helps to call before surgery to make an appointment with your physical therapist.
- Be in the care of a responsible adult.
- Abstain from drinking alcoholic beverages and from smoking.
- You may eat a regular diet, if not nauseated. Drink plenty of non-alcoholic, non-caffeinated fluids.
- Do not make important decisions or sign legal documents.
- Plan to take a few days off work.
Rehabilitation Following Double-Row Rotator Cuff Arthroscopic Surgery
Dr. Millett has specific guidelines for patients who have undergone arthroscopic surgery. These guidelines are broken down into various shoulder rehabilitation phases. Please refer to the Patient Resources section on this website to view a complete and printable version of the rehabilitation program. Depending on the extent of your injury and surgery, the rehab guidelines may vary. These are simply protocols for all patients who have had arthroscopic shoulder surgery.
- Anatomic total shoulder replacement for Shoulder Osteoarthritis
- Arthroscopic stabilization for shoulder dislocations or instability
- Arthroscopic AC repair for treatment of Shoulder Separations (AC Joint Dislocations)
- Arthroscopic treatment of Snapping Scapula or Scapulothoracic Bursitis
- Capsulolabral reconstruction for shoulder instability
- Clavicle (collar bone) fracture fixation
- 'Double-row' arthroscopic rotator cuff repair for Rotator Cuff Tears
- Fracture Fixation Surgery
- General Orthopedic Arthroscopic Shoulder Surgery
- Joint Preservation and Cartilage Restoration
- Reverse Total Shoulder
- Rotator cuff 'healing response' technique for Partial Thickness Rotator cuff Tears or Tendonopathy
- Shoulder Joint Replacement Surgery for Shoulder Arthritis
- Surgery for Sternoclavicular Joint Injuries
- Tendon Transfers for Failed Rotator Cuff Repair
- Use of Autogenous Growth Factors to Accelerate Healing (PRP and ACP)
- Biceps Tenodesis