Rotator cuff surgery is a common procedure performed to repair a torn or damaged rotator cuff tendon in the shoulder. Here’s what you can generally expect in terms of the procedure and preparation for rotator cuff surgery:
Rotator Cuff Surgery: Procedure
Anaesthesia
Rotator cuff surgery can be performed under general anaesthesia, where you are unconscious, or regional anaesthesia, such as a nerve block, which numbs the shoulder and arm area while you remain awake. My preference is a combination of both.
Incisions
The surgeon will make small incisions in the shoulder area to access the torn rotator cuff tendon. The specific technique used can vary, including arthroscopic surgery (small incisions and a camera) or open surgery (larger incision). 99% of my shoulder cuff repair is done through the arthroscopic technique.
Tendon repair
The surgeon will identify and assess the torn tendon and may remove any damaged tissue. The tendon is then reattached to the bone using stitches, anchors, or other fixation devices. These anchors and stitches are all non-metallic.
Additional procedures
Depending on the individual case, additional procedures may be performed, such as acromioplasty (reshaping the acromion bone), which is often done in the case of impingement syndrome. Sometimes biceps tenodesis (reattachment of the long head of the biceps tendon to the upper arm bone) is needed.
Closure
The incisions are closed with sutures, and dressings or a sterile bandage is applied. I usually remove these sutures within a week of the procedure.
Rotator Cuff Surgery: Preparation
Medical evaluation
Prior to surgery, you will undergo a comprehensive medical evaluation, including a physical examination, review of medical history, and any necessary diagnostic tests (e.g., X-rays, MRI) to assess the extent of the rotator cuff injury and determine the most appropriate surgical approach.
Discussion with the surgeon
You will have a consultation with the surgeon to discuss the procedure, expected outcomes, potential risks or complications, and the post-operative rehabilitation process. This is an opportunity to ask any questions or express concerns.
Pre-surgical instructions
The surgeon or healthcare team will provide you with specific instructions to prepare for the surgery. This may include fasting before the procedure, avoiding certain medications or supplements that can interfere with clotting, and arranging for transportation to and from the hospital or surgical center.
Medications
Inform your surgeon about any medications you are currently taking, including prescription drugs, over-the-counter medications, and supplements. They will advise you on which medications to continue or stop before surgery. Usually blood pressure medications need to be continued. Diabetes medications need to be stopped as the patient will be fasting.
Lifestyle adjustments
Depending on your specific case, your surgeon may recommend certain lifestyle modifications, such as stopping smoking or losing weight, to optimise surgical outcomes and promote healing.
Pre-operative testing
You may be required to undergo certain pre-operative tests, such as blood work or an ECG, to ensure you are in good overall health for the surgery.
Arrangements for recovery
It is important to plan for your recovery period, as you may require assistance at home for a few days following the surgery. Arrange for someone to help with daily activities, such as cooking, cleaning, or transportation, if needed.
It is crucial to follow the instructions provided by your healthcare team regarding pre-operative preparations, as well as post-operative care and rehabilitation. Every individual’s situation may vary, so it’s important to consult with your surgeon for personalised guidance and information specific to your case.
Post-operative
The shoulder is usually supported with an arm sling for about 2 days. The post-surgery pain is usually worse in the first few days and gradually improves day by day thereafter. Most patients feel more pain in the night time and not much pain during the day time. Physiotherapy might be needed and your surgeon will advise you accordingly.
