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Risks associated with Rotator Cuff Repair

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.

Tendon re-tear : 6%

Tearing of the rotator cuff following repair does happen. The risks are increased with larger tears and older patients. Tendon re-tear does not guarantee a poor result, return of pain, or poor function but often does mean a loss of strength.

Section 2

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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.

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

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 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.

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