Rotator Cuff Repair

If the symptoms associated with the rotator cuff tear are such that treatment is necessary, a rotator cuff repair can be undertaken.

The aim of the surgery is to initially arthroscopically examine the shoulder to confirm the diagnosis and then create the best surgical environment before undertaking the repair. This will entail a full debridement, where any frayed tendon tissue is removed and any inflammatory tissue, that might be restricting movement, is also removed. A subacromial bursectomy and decompression is usually then undertaken so that a full assessment of the tear can be performed so as to determine how it is to be best repaired. The torn rotator cuff is then mobilised and manipulated to see if it can be returned to the position from which it was torn. If it can, then the repair is undertaken by physically stitching the tendon back to its bony origin, known as the footprint. To enable this, anchors are used to imbed the sutures used in the repair into the bone. Then, using arthroscopic techniques, a repair is completed. This is usually a completely arthroscopic procedure, but occasionally mini-open techniques are also used, to ensure a good outcome. In such instances, the majority of the repair is still performed arthroscopically such that the outcome and recovery times are not adversely affected.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding
• Nerve injury
• Stiffness
• Continued discomfort
• Re-tear

Before admission

• Please bring any X-rays or scans with you to the hospital.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery

In Hospital

• A rotator cuff repair is usually performed as a day case procedure or as a single overnight stay.
• Multiple incisions, each approximately 1 cm in length, are made around the shoulder. These are closed with dissolving sutures and Steri-strips.
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your out-patient physiotherapy commences.

What to Expect

• Swelling; Immediately after an arthroscopic procedure there can be quite a lot of swelling around the shoulder but this settles after approximately 24 hours. A cryocuff or alternative cold therapy compress can be helpful in minimising swelling and inflammation.
• Pain; An interscalene block is often used to reduce immediate post-operative pain. If any discomfort arises after 18-24 hours once the block has worn off simple oral analgesics can be taken to manage this.
• Bleeding; There may be some oozing through the bandages but this should settle soon after the operation.
• Stiffness; Due to the amount of work undertaken during a rotator cuff repair, the shoulder will be prone to becoming stiff following the operation. It is therefore essential that the postoperative physiotherapy program is followed after your discharge from hospital. This will help reduce the risk of stiffness and help ensure a good outcome.

Post-operative care

• A sling will be provided to help rest the shoulder. This is usually used for the first 6 weeks post surgery. To prevent the development of undue shoulder stiffness, the belt that is attached to your sling should be removed 24 hours after your operation. However, you may wish to wear it at night to help protect your shoulder.
• The wound should be kept dry for 10 days.
• At ten days, the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound. If not, please consult Mr Falworth or your GP for further advice.
• The most important part of your post-operative care is to start an early physiotherapy exercise programme, which the ward physiotherapist will have commenced prior to your discharge from hospital. This will maximise the benefit of your operation and will continue as an outpatient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

Estimated return to functional activities