A complete rotator cuff tear usually requires surgery in order to return the shoulder to optimal function. Optimal function means to relieve pain, restore strength, function and range of movement. A complete rotator cuff tear will not heal by itself.
A rotator cuff repair involves stitching the torn tendon back onto its attachment to the arm (Humerus) and it is normally performed through keyhole surgery (Arthroscopy).
How is Rotator Cuff repair performed?
Steps of surgical procedure:
The tear is viewed via the scope and portals (small holes in the skin) are created for instrument insertion
A suture is passed across the long limb of the tear from side to side, using a special instrument, called a suture passer.
The suture is tied and the two ends of the tendon brought together. This process is then repeated until the long limb of the tear is repaired.
The bone is prepared for the insertion of the suture anchors
The suture anchor is inserted with a long insertor. The insertor is removed, exposing the sutures which are attached to the anchor.
Arthroscopic and cross-sectional views of the suture anchor in the bone, with the sutures arising from it
Suture from anchor pulled through the tendon with a special suture retrieving forceps. The anchor sutures are the passed across the rotator cuff tendon.
Further suture anchors are added, as required depending on the size of tear.
What to do after Rotator Cuff Repair
Following surgery, patient will normally be discharged on the same day or the very next day with the bulky dressing over the knee area. The bulky dressing will then be removed clinically 3 days after the surgery.
The length of time that you will be off work will depend on your job but expect a minimum of 3 weeks for minor tears, increasing to possibly 6 months if work involves heavy duties.
Physiotherapy will be organised for when you leave hospital for 2 to 3 times per week and may well continue for weeks or months after the surgery.
You will be guided through the rehabilitation programme by your physiotherapist.
It is of the utmost importance that you stick strictly to this programme.