Rotator Cuff Tear
In intact rotator cuff tendon is essential for maintaining normal shoulder function. Tears in this inner tube of tendons within the shoulder joint can cause severe pain particularly at night, weakness and functional loss. A torn tendon is diagnosed both clinically but with imaging including either an ultrasound or an MRI. Treatment depends on multiple factors, including the age and activity of the patient and any comorbidities but also the size and type of the tear.
Rotator Cuff Repair Surgery
Once the decision has been made to repair your rotator cuff a number of small incisions are made around the shoulder for the insertion of the arthroscope and the equipment needed to stitch your tendon back onto the bone. Almost all repairs now are done with arthroscopic/keyhole surgery. The operation can be done under either a general or regional anaesthetic. Small instruments are passed through these tiny incisions into the shoulder to allow stitches to be passed through the tendon. The repair may involve more than one layer of sutures. The bone is freshened where the tendon needs to be reattached to and the sutures are attached to special anchors that sit within the bone and then tendon repair is then tensioned onto those anchors. The anchors can be made of bio absorbable material, plastic or metal. The surgery takes approximately 45 – 60 minutes and can be done as a day case. Post operatively patients’ needs to be immobilised in a sling for four weeks after which they need to commence typically an eight week post-operative physiotherapy programme.
The outcomes of rotator cuff surgery are normally good as surgeons will normally only repair those tendons that are going to do well with this type of procedure. Sadly some rotator cuff tears are irreparable in that if the tendon has been torn for a long time it will have become very thin and the muscle attached to it can become shortened and infiltrated with fat so that the tendon cannot physically be stretched far enough to allow it to be reattached correctly to the bone. All of these issues will be carefully discussed with you prior to any surgery correlating the clinical findings with your imaging.