Advice on Rotator Cuff Repair
Before embarking on rotator cuff repair you should
be aware of the following facts. If you have any other questions you should ask your surgeon for further information.
Benefits
- Relief of pain: Approximately 85% of
patients can expect to obtain good pain relief from surgery.
- Range of movement: Rotator
cuff tears are normally associated with a reduction in the
range of shoulder movement. Repair of the cuff may improve
this, but the results of surgery are somewhat unpredictable.
Risks
General risks
associated with any surgery
-
Cardiovascular problems: Heart attack and
stroke can occasionally be caused by anaesthesia and surgery.
The risks of this complication are normally exceedingly small in
healthy individuals. The risk may be greater if you have
pre-existing disease, in which case your anaesthetist / surgeon
will discuss this with you.
-
Thromboembolism: Blood clots may
sometimes form in the veins of your legs, a condition known as
'deep vein thrombosis.' This may cause excessive swelling of
your legs and may require treatment with blood thinning drugs.
Extremely rarely the clot may become detached and travel to the
lungs; this is a potentially fatal complication known as a
'pulmonary embolus.' There are some conditions in which the risk
of thromboembolism is increased (e.g. patients on the
contraceptive pill or HRT), in which case you may be given
medication to reduce the risk.
Specific risks of
subacromial decompression
-
Failure to relieve symptoms: Up to 15% of
patients do not respond to surgery. The majority of these
patients find their symptoms similar to those prior to surgery.
-
Progression of pathology: Rotator
cuff repair will not necessarily prevent progression of
rotator cuff disease. Deterioration in symptoms may therefore
occur at a later date.
-
Infection: Infection can complicate any
surgery. Infection following repair of a small rotator cuff tear
is relatively uncommon, but the risk rises with the size or
the tear and the extent of the surgery; following repair of
a very large tear the risk may be as high as 5%.
In the event of an infection further surgery may be
required.
-
Stiffness: There is a small risk that
your shoulder may be more stiff after surgery. The risk is
particularly great if you develop a post-operative
infection.
Surgery details
-
Surgery will be done under general anaesthesia.
Your anaesthetist will discuss this with you. You may also have
a local anaesthetic injection to control post-operative pain;
again this will be discussed prior to surgery
-
The operation will take about 1
hour
-
An arthroscopy of the shoulder is often performed first (see
information sheet on subacromial decompression). It is
sometimes possible to repair the cuff arthroscopically
through 2 or 3 very small incisions, but more frequently an
incision 5 to 10 cm long is made over the top of the
shoulder.
-
After surgery the arm will be immobilized in a sling.
-
It is usual to stay in hospital on the night following
surgery.
Recovery
-
You will be encouraged to
do gentle 'pendulum exercises' on the shoulder. These should
be done several times a day. At all other times however you
should wear a sling.
-
Depending on the extent of your surgery you should continue
wearing your sling for 3 to 6 weeks.
-
After your sling has been removed you will require
physiotherapy to mobilize your shoulder.
-
Recovery following cuff repair is slow. It frequently
takes 3 months to regain a functional range of movement for
simple everyday activities and full recovery often takes 12
months. You should not consider doing any lifting for 3
months.
-
It is normally possible to drive 6 to 12 weeks after
surgery.
-
Your progress will be monitored by periodic outpatient
appointments.
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