Rotator Cuff Repair
Rotator cuff repair surgery is performed to repair a torn or impinged tendon in your shoulder known as your rotator cuff.
What is a rotator cuff injury?
Your rotator cuff is a term for the group of four tendons and muscles that surround your shoulder joint. They allow you to move your shoulder up, down, backwards, forwards, and to rotate it.
Your rotator cuff can be torn or become impinged.
A rotator cuff tear is a common injury. It can be caused by a fall to your shoulder, wear and tear from repetitive movements, or strain on your tendons.
Rotator cuff impingement is caused by overuse of the soft tissues in your shoulder and rotator cuff. It can become inflamed, thickened, and worn by the bone on the top of your shoulder rubbing against your rotator cuff tendon.
What are the symptoms of a rotator cuff injury?
A rotator cuff injury will cause you pain and discomfort. You may feel a burning or tingling sensation in your shoulder joint and the pain can radiate down your arm. Pain can often get worse if you’re doing something with your arm above your head or at night, especially if you sleep on your injured shoulder.
You may suffer from a limited range of motion and you may find it difficult and painful to do everyday tasks, such as getting dressed.
When do you need treatment for a rotator cuff injury?
If you have shoulder pain and you think you may have a rotator cuff injury you should see your doctor or a physiotherapist. They will ask about your symptoms, your activities, and for you to do some shoulder movements. They may recommend further tests to see inside your shoulder including:
- an ultrasound scan
- a shoulder x-ray
- a MRI scan
They may refer you to a specialist orthopaedic surgeon or a doctor who specialises in joint conditions. Ramsay hospitals offer onsite diagnostic services and access to orthopaedic specialists.
Treatment options for rotator cuff injury
Your treatment will depend on the extent and type of rotator cuff injury you have.
There are some things you can try to help yourself such as resting your shoulder when you can, not lifting heavy weights, or performing activities where you need to lift your arm over your head. Pain relief can be gained from over the counter painkillers, such as paracetamol or ibuprofen.
Physiotherapy may be recommended to improve your shoulder’s strength and movement. A physiotherapist will offer advice on specific exercises for you to do at home. Your exercise programme will depend on your specific injury. Here at Ramsay, our physiotherapists are fully trained and experienced and will develop a plan with you to ease your rotator cuff injury symptoms.
A steroid injection may be recommended if other treatments don’t work, your pain is severe or your movement is limited. The injection is placed in the area around your shoulder joint. It aims to reduce the swelling, pain and stiffness. Physiotherapy may be easier in conjunction with steroid injections that relieve your symptoms. Our consultant orthopaedic surgeons are able to administer steroid injections.
Rotator cuff repair surgery is often an option if other treatments haven’t been successful or you have a large rotator cuff tear. It aims to ease your pain and offer you as much movement in your shoulder as possible.
When would rotator cuff repair surgery be recommended?
Your doctor may offer surgery as an option for a torn rotator cuff if you have continued pain despite trying non-surgical methods or if you normally use your arms for sports or overhead work. As a general rule surgery may be considered if:
- You have had symptoms for six to twelve months.
- Your tear is more than three centimetres and you have good quality surrounding tendon tissue.
- You have significant function loss and weakness in your shoulder.
What does rotator cuff repair surgery involve?
Rotator cuff repair surgery can be performed as open or keyhole surgery.
Open surgery involves making a large cut over your shoulder skin and is generally used for large tears or to remove bone spurs from the underside of your acromion so that the rotator cuff tendon is no longer rubbing against the bone.
Keyhole surgery, such as shoulder arthroscopy, is performed by passing a tiny camera and instruments through very small incisions to see inside and treat your shoulder joint. It is an outpatient procedure and does not require an overnight stay in hospital.
Your orthopaedic surgeon will discuss with you the best procedure to meet your individual needs.
What are the benefits of rotator cuff repair surgery?
The primary benefit of rotator cuff repair surgery is pain relief. Additionally, by repairing your tendon you will gain improved shoulder strength and function so that you can perform a greater range of movement at your shoulder joint and do more with your arm.
What are the complications of rotator cuff repair surgery?
As with any surgical procedure, there may be complications. General risks include: blood loss, problems related to the anaesthetic, wound infection and scarring.
Specific complications of rotator cuff repair surgery include:
- Nerve injury
- Deltoid detachment - in open repair surgery this shoulder muscle is detached and stitched back into place.
- Stiffness – this may be improved with exercise.
- Tendon re-tear - the larger the tear, the higher the risk of re-tear, although patients with a re-tear do not usually have the pain or decreased shoulder function as that before their surgery, so repeat surgery may not be required.
How long will recovery be after rotator cuff repair surgery?
You can expect a complete recovery from rotator cuff repair surgery to take six to twelve months. You will work with your physiotherapy team to develop a rehabilitation plan designed to gradually build up your exercises to help strengthen your shoulder and regain its full movement.
You may need to take several weeks off work.
Your recovery will be quicker if you have had keyhole surgery as opposed to open surgery.