Rotator Cuff Repair

What is a Rotator Cuff?

The Rotator Cuff is made up of four muscles and their tendons, which form a cuff over the upper arm (humerus). These four muscles originate from the shoulder bade (scapula) and are responsible for lifting and rotating the arm and stabilizing the 'ball' of the joint within the 'socket' of the shoulder.

What is a Rotator Cuff injury?

A Rotator Cuff injury is an injury that causes pain, crepitus (cracking), restricted shoulder movement and joint weakness in people who are typically over the age of 40 and who work in occupations or play sport that require repetitive overhead arm movement. The most common type of occupations and sports that cause this type of condition are seen from painters, decorators, swimmers, tennis players and bowlers. This condition can also be caused by abnormal pressure building up within the shoulder joint space, typically caused by the shoulder blade (scapula) repeatedly rubbing on the rotator cuff over time. The cuff tear can be partial of full and in the more severe cases will involve damage to other shoulder structures and surrounding tissues.

How is a Rotator Cuff injury treated without surgery?

The use of regular anti-inflammatory medications and enforced rest of the affected shoulder joint for several months can often successfully alleviate this condition if it is caught at an early enough stage. In addition, physiotherapy aimed at progressively relaxing the swollen Rotator Cuff muscle and building up general shoulder strength can also prove useful in avoiding a re-occurrence once an improvement of symptoms is achieved.

How is a Rotator Cuff injury treated with surgery?

A surgical procedure to resolve a Rotator Cuff injury is typically avoided for all but the more severe and debilitating cases and those that have failed to respond to conservative treatment.

Surgical intervention is aimed at repairing and freeing the damaged or trapped Rotator Cuff, repairing any other damaged tissues and clearing sufficient space around the cuff and within the joint space to allow free movement without any rubbing from the Scapula. In some cases creating sufficient space for the joint to move as freely as it needs may involve a decompression procedure known as a Subacromial Decompression, whereby the anterior edge of the acromian on the Scapula is removed.

This procedure can be performed under general anaesthetic (you will be asleep) or under regional anaesthetic (you will be awake) and will take around an hour to two hours to perform dependant on the complexity of the condition.

It is increasingly common for this procedure to be performed arthroscopically (by 'keyhole' surgery) and further information can be obtained on this particular surgical method by consulting our alternative fact sheet entitled 'Shoulder Arthroscopy'. (Ken - please link to Shoulder Arthroscopy her)  

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid joint stiffness and other complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be encouraged to take a short walk and perform gentle postoperative exercises with guidance from a physiotherapist on the day of surgery.

Following a progressive improvement of mobility and pain control patients are normally discharged from hospital 24 hours following surgery. By the time the required level of recovery is achieved for discharge, patients are normally fully mobile, wearing a light weight dressing and support sling on the effected shoulder, eating and drinking normally and taking only mild analgesia (pain killers).

Over the next 6 weeks patients will be expected to work on improving their new shoulder joints mobility and stability through a dedicated and progressive upper limb physiotherapy regime.

Your Consultant Surgeon will assess your joints stability and range of movement after 6 weeks and then again after three months to evaluate how successful your shoulder procedure has been. Patients should expect a continuous and full physical recovery to take around four to six months to achieve.

Are there any risks associated with Rotator Cuff repair surgery?

Although Rotator Cuff Repair surgery is regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking this type of specialist upper limb surgery.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation with an expert in shoulder surgery to discuss your condition in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for Rotator Cuff repair surgery?

Surgical Advisor will be delighted to help you find a leading expert in shoulder surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating complex shoulder surgery and because of their specialist upper limb surgical expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert upper limb orthopaedic surgeon: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com