Rotator Cuff Repair Surgery

What is rotator cuff repair surgery?

A shoulder rotator cuff repair is a surgery to repair torn muscles at the shoulder joint.

The shoulder joint is a ball and socket connection supported by a group of muscles and tendons that facilitate a wide range of 3-dimensional movements.

Acute injury, overuse and strain can cause tears in the rotator cuff muscles. Age-related wear and tear can also cause tendon degeneration.

How it works

Rotator cuff tears can be either partial or complete. A muscle that is frayed or damaged is considered a partial rotator cuff tear. A complete tear is when the damage extends all the way to the tendon or pulls the tendon off the bone.

Although rotator cuff tears can sometimes go unnoticed, especially if there is no shoulder pain, it is quite common to experience symptoms such as:

• Clicking or popping sound with movement
• Difficulty reaching behind the back
• Pain and tenderness during shoulder movement
• Progressive weakness of the shoulder
• Reduced range of movement

When do you need rotator cuff repair surgery?

Minor injuries to the rotator cuff can be managed non-surgically with:

• Anti-inflammatory medication to reduce swelling and pain
• Hot or cold packs
• Rest
• Rotator cuff exercises to restore muscle strength and increase motion range

You will need to undergo shoulder rotator cuff repair if you have serious or complete rotator cuff tears or injuries which do not heal completely. If left untreated, these symptoms could lead to frozen shoulder and arthritis.

Your doctor will suggest surgery when there is significant loss of shoulder function or persistent symptoms that are unresponsive to non-surgical treatment.

What are the risks and complications of rotator cuff repair surgery?

Shoulder rotator cuff repair is a safe procedure, with low risk of complications. However, like any other surgery, it carries a small risk.

Common surgical complications include:

• Allergic reactions to anaesthesia and other medication
• Breathing problems
• Bleeding, blood clots and infection
• Injury to tendons, blood vessels of nerves
• Permanent joint stiffness
• Recurrent tears of the rotator cuff

How to prepare for a rotator cuff repair surgery

Talk to your surgeon before going for surgery about:

• Any health condition or allergies you have. This should also include all medications you are currently taking.
• Any unprescribed medication and health supplements. Avoid taking them unless they have been cleared by your doctor.
• Arranging for assistance after the surgery.
• Optimising your general health. Do stop smoking at least a month before surgery.
• Suitable attire for the procedure. You may want to wear loose fitting clothes that are easy to put on and fasten.

What to expect for a rotator cuff repair surgery

Surgical treatment of rotator cuff tears can be performed as:

Open repair surgery. An open repair is usually recommended for larger and more complex tears that requires general anaesthesia. Arthroscopic shoulder surgery. Shoulder arthroscopy is less invasive and can be done in a day surgery or outpatient setting.

During the procedure

For partial tears, the muscles may only require debridement or trimming.

For complete tears, the surgeon will reattach the tendon to the head of the humerus using suture anchors. These anchors are then attached with sutures to tie or attach the tendon back to the bone. Suture anchors do not need to be removed after the tendon has healed.

Care and recovery for rotator cuff repair surgery

Your shoulder, and even your arm or hand, will be sore and swollen after surgery.

You will need to wear a shoulder immobiliser. The duration for wearing the immobiliser will depend on the type of surgery.

A sling will be required after that for about 6 weeks to support the arm and restrict shoulder movement. During this period, movement of the affected shoulder is limited.

You should avoid activities such as:

• Driving
• Lifting
• Pulling

You should continue to:

• Use your fingers and hands
• Keep the incision dry and clean
• Keep an eye out for redness, discharge, tingling or numbness in the arm, hand or fingers
• Manage pain with medication
• Rest well for better and faster recovery