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Arthroscopic Rotator Cuff Repair

A complete rotator cuff tear will not heal. Complete ruptures usually require surgery if your goal is to return your shoulder to optimal function.

A rotator cuff repair involves stitching the torn tendon back onto its attachment to the arm bone (Humerus). This may be performed either through keyhole surgery (Arthroscopy) or open surgery, using sutures and bone anchors.

The advantages of repairing a rotator cuff tear arthroscopically (keyhole surgery) are:

  1. Less post-operative pain
  2. Less time in hospital (usually can be performed as a day-case operation)
  3. Quicker return to work and sports
  4. Usually no stitches to remove
  5. Less wound complications

However, it is more technically demanding to perform arthroscopically and different skills and equipment are required to those used in open surgery.
Click fo our Results of Arthroscopic Rotator Cuff Repair 


GENERAL ADVICE

You should not eat or drink anything after midnight the night before the procedure.

You will usually be in hospital for no more than one day. Most people will be able to go home the same day (daycase)

Your surgeon and a physiotherapist will see you prior to discharge and you will be taught exercises to do and given further advice to guide you through your recovery.

For more information click here

Your arm will remain in a shoulder sling for about least 3 weeks. You mainly wear the sling when out and about and for sleeping, but can remove it for dressing, bathing and light activities as guided by your physiotherapist. It does mean that you will be unable to use the arm throughout this time for most other activities. For more details on Living with a Shoulder Sling Click Here

An appointment will be made for you to see the surgeon or specialist therapist 3 weeks post-operatively.

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 and may well continue for some 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.

Click here for the Post-operative rehabilitation Protocol


SURGICAL PROCEDURE

 Click here for Interactive Animations

Below is an example of the steps in an Arthroscopic cuff repair

Step 1: The tear is viewed via the scope and portals (small holes in the skin) are created for instrument insertion


Step 2: A suture is passed across the long limb of the tear from side to side, using a special instrument, called a suture passer.

Step 3: 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.


Step 4: The bone is prepared for the insertion of the suture anchors 

Step 5: The suture anchor is inserted with a long insertor. The insertor is removed, exposing the sutures which are attached to the anchor.


Step 6: Arthroscopic and cross-sectional views of the suture anchor in the bone, with the sutures arising from it.

Cross-sectional view of the anchor in the bone
Cross-sectional view of the anchor in the bone

Step 7: Suture from anchor pulled through the tendon with a special suture retrieving forceps. The anchor sutures are the passed across the rotator cuff tendon. 
 
Arthroscopic view of the suture being retrieved through the cuff tendon 
Step 8: The sutures are passed through the tendon.

Step 9: The sutures are then tied sequentially
 


Step 10: Further suture anchors are added, as required depending on the size of tear and steps 5-9 are repeated for each anchor until the tear is fixed to the bone

Final Repair:


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