Shoulder Surgery Rotator Cuff Repair

Indications for operation

Rotator cuff rupture

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Anaesthetic

General Anaesthetic with an interscalene block (Fully asleep with a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type

If the rupture can be repaired through the arthroscope it will be. Very large tears require an open operation

Arthroscopic repair

Incisions

Figure 1
Arthroscopic repair incisions

3-4 ½ cm incisions will be made in the shoulder, one to the back, one at the side and one at the front of the shoulder.

Procedure

The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. A soft tissue shaving device will be used to clear any scar tissue away. A bone-shaving device will be used to shape the underside of the acromion (the bone at the top of the shoulder) and remove any excess bone.

The edges of the cuff tear are tidied with the soft tissue shaver and sutures passed through the edge. The sutures are attached to small anchors (screws) in the bone and the cuff is reattached to the bone using these anchors.

Images

Figure 1 Figure 2
Shoulder Anatomy - front view                                         Shoulder muscles (rotator cuff) - side view
 
Rotator cuff tear Inserting sutures
Cuff tear - pre op                                                             Cuff tear - inserting sutures
 
Passing sutures Completed repairs
Cuff tear - passing sutures                                                 Cuff tear - completed repair

Animations of the Arthrex Speedfix and Speedbridge techniques for rotator cuff repair

Wound Closure

Small butterfly paper stitches will be used to close the wounds.

Dressings

Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare

An adhesive dressing will be placed over the wound and the arm will be placed in a splint to keep the arm lifted away from your side. This splint must be worn for several weeks. You can go home when you feel comfortable and will be given instructions on what to do next.

Figure 1
Abduction sling

Further instructions for Rotator Cuff Repair rehabilitation

Download postoperative instructions