Indications for operation

PASTA Lesion (Partial Articular Sided Tendon Avulsion)

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

Risks

All surgical procedures have some element of risk attached.
The risks outlined below are the most common or most significant that have been reported.

Continued pain: 5%.

Usually all the pain is removed. Some patients experience mild pain on overhead activities. Rarely is the pain not improved by surgery.

Infection: less than 0.1%.

If an infection does occur it is usually superficial in the wounds and is easily treated with antibiotics Rarely the infection can be deep inside the joint and this requires surgery to wash the joint out.

Nerve damage: less than 0.1%.

The axillary nerve runs close to the bottom of the joint and, if damaged causes weakness of the deltoid muscle and difficulty in raising the arm.

Stiffness: 1%.

The shoulder will often become stiff after surgery and this usually settles with physiotherapy. Rarely the shoulder can become very stiff and require manipulation or arthroscopic release surgery.

Incisions

Three or four 5mm 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 and prepare the insertion site. A small anchors (screw) is passed through the tendon and into the bone. The sutures are passed through the tendon and tied down in the subacromial bursa, securing the tendon.

Anatomy of the shoulder

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 to rest the arm for 2 weeks. You can go home when you feel comfortable and will be given instructions on what to do next.