North Hampshire Hospital
The Hampshire Clinic
Basingstoke, Hampshire, UK

Mr John Britton FRCS
Consultant Orthopaedic Surgeon

Information for patients undergoing orthopaedic treatment

 


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.

 

For further information please see  www.johnbritton-orthopaedics.co.uk

John Britton FRCS
Consultant Orthopaedic Surgeon

J M Britton 2007

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