There are four tendons involved in the movement of your shoulder, collectively called the rotator cuff. Sometimes these tendons get compressed and tear - through injury, inactivity or the ageing process. This can cause pain which limits your normal range of motion and everyday activities. Rotator cuff repair surgery fixes the tears in these tendons.
The rotator cuff tendons are attached to your shoulder blade at one end and the top of your upper arm (humerus) at the other. They pass through a narrow space before attaching to the top of your upper arm and this space can become increasingly narrow over time due to the formation of a spike of bone, or the thickening of a ligament.
This causes increased pressure on the tendons, making them inflamed and painful. If the pressure is not relieved they can be damaged and ultimately tear and cause rota tor cuff injury.
You might need surgery to repair the damage, with your treatment dependant on the size of the tear.
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You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
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Our dedicated team will also give you tailored advice to follow in the run up to your visit.
We understand that having surgery can potentially be a time of anxiety and worry. Our experienced and caring medical staff will be there for you, holding your hand, every step of the way.
During rotator cuff repair surgery, we will perform a subacromial decompression to help relieve the pain associated with the tear. The subacromial area is the space between the top of your upper arm bone (humerus) and the small bone attached to the top of your shoulder blade (acromion). Subacromial decompression opens up this space and reduces the pressure on the muscle by cutting the ligament and shaving away the bone spur on the acromion bone, which allows the muscle to heal.
Small tears to rotator cuff tendons can be treated by arthroscopic repair (which is repair through a small incision) or, if very small, they can be left untreated. Repair to small tears can be done with an overnight stay in hospital.
Larger tears generally need to be repaired, with both small incision and open surgery techniques used depending on the size and location of your tear. Arthroscopic repairs use suture anchors (dissolvable plastic pegs with strong sutures attached), which are placed into the bone. The tendon is sutured down to the anatomic insertion site. Typically, there will be between 3 and 5 small incisions for this type of surgery.
For open surgery, an incision of between 4 and 8 centimetres is made on the side of the shoulder and the torn tendon reattached to bone with sutures.
You'll usually need to stay in hospital for at least one night following this surgery. After the procedure, you'll be taken from the operating theatre to a recovery room, where you will come round from the anaesthesia under close supervision.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you’re ready to go home.
While you are in hospital you may be referred to a physiotherapist who will help you with exercises that will help speed up your recovery.
If you need them, continue taking painkillers as advised by the hospital.
We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.
Typically, you'll spend the first three weeks after surgery with your arm in a sling with minimal movement to allow the repair to heal strongly. Between three and six weeks, you may start physiotherapy to regain movement in your shoulder, which will be quite stiff by this time. The final phase is between 8-16 weeks, when you will start strengthening exercises.
If it is deemed appropriate by your surgeon, you may be able to restart some sports after four months, but you should avoid heavy lifting and contact sports for six months after surgery.
Once you’re ready to be discharged from hospital, you’ll need to arrange a taxi, friend or family member to take you home as you won’t be able to drive.
As your arm will be in a sling for the first three weeks after surgery, you may find that some routine daily activities, such as shopping, are difficult for a few weeks and you’ll need some help with light errands.
You must follow your surgeon's advice about driving and returning to work. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort.
Even after you’ve left hospital, we’re still looking after you every step of the way. After rotator cuff repair, we will provide you with all the appropriate medication, physiotherapy exercises, advice on what to do and not to do with your shoulder and follow-up medical support.
Typically your consultant will want to see you after your treatment to see how you’re doing. You might also be seen by a physiotherapist. A follow up appointment will be made for you before you leave the hospital.
On rare occasions, complications following rotator cuff repair can occur. The chance of complications depends on the exact operation you are having and other factors such as your general health. Ask your surgeon to explain how.
We will talk to you about the possible risks and complications of having this procedure and how they apply to you.
If you have any questions or concerns, we’re ready to help.
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.