Shoulder Surgery Superior Capsule Reconstruction

Indications for operation

Irreparable 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

Arthroscopic 

Incisions

Figure 1
Arthroscopic repair incisions

4-5 ½ cm incisions will be made in the shoulder, one to the back,3 at the side and 1-2 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. The top of the glenoid (socket) and the greater tuberosity (where the cuff normally attaches to the humerus or arm bone) are prepared. Stitches are attached to the bone using small screw type anchors. These stitches are passed through a specially prepared graft which is made of either porcine (pig) or human tissue.

The graft is introduced into the shoulder and the stitches are tied down securing the graft between the socket and the arm. This reproduces some of the function of the native rotator cuff.

Images

Figure 1 Figure 2
Shoulder Anatomy - front view                                         Shoulder muscles (rotator cuff) - side view
 
 

Animation of the Arthrex Superior Capsule Reconstruction procedure

   

Video of the Superior Capsule Reconstruction Procedure

   

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 sling. You are allowed to take the arm out of the sling to perform basic tasks for 4 weeks before physiotherapy starts. You can go home when you feel comfortable and will be given instructions on what to do next.

Further instructions for Superior Capsule Reconstruction rehabilitation