Shoulder & Elbow : Rotator Cuff Repair

What is the Rotator cuff?

Your shoulder is the most mobile joint in your body and is therefore dependant on strong muscles to allow movement and provide stability. The most important of these muscles are your rotator cuff
muscles. These are four muscles which originate from your shoulder blade (scapula) and combine together to form a hood covering the ball of your shoulder joint. These four rotator cuff muscles are individually called Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. The tendons of these muscles can become damaged in two ways; either due to an accident such as a fall onto your arm; or due to weakening over time.

What happens during a Rotator cuff repair?

During a rotator cuff repair, your surgeon will examine your shoulder to find any tears in the muscles or tendons and then fasten them back into place again. The bone on the underside of the acromion may also be smoothed out. The acromion is the arch of bone at the end of your shoulder blade, which acts as a bony roof over the rotator cuff.

How is the operation carried out?

The operation is carried out under a general anaesthetic, usually as a day case. This means you will go home on the day of your operation. Some patients who have other medical conditions may require an overnight stay in hospital.

It may be done as either open surgery or by keyhole (arthroscopic) surgery.

What are the benefits of having a rotator cuff repair?

A rotator cuff repair may be offered to you if the tear in your muscle/tendon is causing pain in your shoulder. You may also be finding it difficult to move your arm and be struggling with lack of strength. It is normal to feel discomfort following the operation but a rotator cuff repair can relieve a lot of the pain previously experienced. Following rehabilitation after the surgery you should also begin to see improved movement of your shoulder, and eventually an increase in strength. It can take up to three months for the repair to the muscles and tendons to heal, and you may still be seeing improvements in your shoulder up to 18 months after your surgery.

Are there any complications of having a rotator cuff repair?

As with most types of surgery there are risks involved and complications can occur unrelated to the rotator cuff repair.

Some other complications, which can occur specifically following a rotator cuff repair, are:

  • Infection: can be a serious complication. Some infections show up immediately whilst you are still in hospital, others are not apparent until you have gone home. If you are at particular risk your surgeon may recommend that you take antibiotics.

  • Re-tearing of the rotator cuff: is possible following surgery before the rotator cuff has fully healed. This is why it is important to wear your sling as directed. Your therapist will instruct you carefully about exercises to minimise this risk.

  • Ongoing pain and stiffness in the shoulder: is possible especially if you do not continue with your individual home exercise plan. To minimise this risk you will be given exercises by the therapists before you leave hospital. If your shoulder is particularly stiff the physiotherapists may need to see you before surgery to help you gently stretch your shoulder.

These risks are very small but if any occur, further treatment or an operation may be necessary.

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