You have been diagnosed with a shoulder rotator cuff tendon tear and have been scheduled for shoulder rotator cuff tendon surgery.
What to expect?
Pre-Admission
I generally do not need to do pre-surgery blood tests, ECG or chest x-rays unless the patient has significant pre-existing chronic illnesses such as heart failure, renal failure etc.
Certain hospitalisation insurance companies may require pre-authorisation. Please let us know and we can do this for you.
Sleep well the night before the surgery. No need to worry as it is generally a safe procedure.
On the Day of the Surgery
Do fast with no intake of food or drinks for 6 hours before the scheduled surgery time.
If you are taking any high blood pressure medications, do take the medications on the day of the surgery even if you are asked to fast. Just take the medications with a sip of water.
Do arrive at the hospital’s admission office 2 to 3 hours before the scheduled surgery time as there is paperwork to be done at admission and to get to the ward.
Surgery
You will be taken to the operating theatre suite. The nurses, anaesthetist and surgeon will talk to you before the surgery. There will be verification of which shoulder is to be operated on in order to prevent wrong site surgery.
I always request my anaesthetist to provide a single shot nerve block to numb the shoulder to be operated on before starting general anaesthesia. This serves 2 purposes: It blocks pain sensation during the surgery and hence the patient who is under general anaesthesia will not have any pain response to the surgery and the blood pressure will not go up. This helps to reduce bleeding making surgery easier and faster. Secondly, it provides up to 6 hours of post-surgery pain relief once the patient wakes up from general anaesthesia.
I routinely record the surgery which is done using keyholes and with a camera inside the shoulder. The patient gets to view the surgery in the clinic and better understand what was done during surgery.
Post-Surgery
The operated shoulder will be supported by an arm sling for the next 2 to 3 days. It can be removed thereafter.
My patients usually go home the day after the surgery.
The surgery usually has just 4 small holes around the shoulder and these will be covered with water resistant plasters. Hence my patients can just shower without need for added protection from shower water.
My patients will be taught 4 simple passive range of motion exercises for the operated shoulder. They will do it regularly throughout the day.
Expected Recovery
The stitches are usually removed at about a week post-surgery. Don’t worry, removal of stitches is not painful.
Patients are given oral anti-inflammatory medications for the first few weeks after surgery. The repaired tendon heals to the bone through inflammation. This can cause pain in the shoulder post-surgery. Hence anti-inflammatory medications will be useful.
I usually refer patients to start physiotherapy at about 5 to 6 weeks AFTER the surgery.
My patients will be allowed active movement of the operated shoulder at about 6 weeks AFTER the surgery as the tendon would have healed to bone by that time.
Most patients require physiotherapy for 2 to 3 months to achieve good and strong movements of that shoulder.
