Rotator Cuff Repair
What is it?
Using arthroscopic or keyhole surgery, a camera and surgical instruments are passed through three 4mm (1/4″) incisions. The torn tendon and the bone where the tendon was attached are then cleaned of scar tissue. Depending on the size of the tear, a number of plastic or metal anchors are placed in the bone and the tendon is stitched to them. This will hold the tendon in place while the tendon heals to the bone over a three month period. During this time, you will begin to rehabilitate your shoulder with the help of a physiotherapist.
The surgery is done with an anaesthetic block which will numb the arm. You can be awake during the operation or you can have some sedation to make you sleepy. As the operation uses water to see inside the joint, the wounds will leak some fluid which will be absorbed by cotton wool dressings. These dressings are removed a few hours after surgery. You will see a physiotherapist who will give you some exercises to do, and you can go home the same day.
What should I expect during recovery?
Once the anaesthetic has worn off after approximately 4-8 hours, the shoulder can feel painful so you will need to take regular pain relief. Even though you may be pain free at rest, you should take regular pain relief for when you move the shoulder as part of your rehabilitation program. A combination of paracetamol or codeine should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, unless contraindicated. If the pain relief is not sufficient please contact your consultant’s secretary or your GP.
The ward nurses will change your dressings and should provide some waterproof dressings to take home with you, so that you can bath or shower keeping the wounds dry. You will also be given a sling which will protect your shoulder and help with pain relief. You will be shown how to use this before you leave the hospital. Following this you can go home the same day.
You will need a dedicated physiotherapy program after your surgery. If you have been seeing a physiotherapist prior to your surgery, you should arrange to see them afterwards so you can start your rehabilitation straight away. If you do not have a physiotherapist we can arrange a referral for you.
Once the sling is removed, exercises to rehabilitate the ligaments will be started. These will improve the range of motion in your shoulder and prevent scarring as the ligaments heal. Exercises to strengthen your shoulder will gradually be added to your rehabilitation plan. Be sure to follow the treatment plan. Although it is a slow process, your commitment to physiotherapy is the most important factor in returning to all the activities you enjoy.
When can I return to driving?
You can return to driving after 6 weeks.
When can I return to work?
You can return to a sedentary job such as office work after 3 weeks. Most patients return to light manual work at 6 weeks and heavy labour at 8-10 weeks.
When can I return to exercise?
As a guide, you can return to breast stroke swimming after 6 weeks, but freestyle swimming is not advised until after 3 months. Golf and contact sports should also be after 3 months.
The One Team Specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
