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Shoulder - Rotator Cuff surgery

What is the rotator cuff?

Shoulder pain can result from rotator cuff injuries

The rotator cuff is formed by four muscles and tendons, which attach your upper arm to the side of the shoulder blade, just under the collar bone. If the rotator cuff becomes weak or tears, then pain and weakness in the shoulder can result.

How can the rotator cuff be damaged?

There are usually two ways that the rotator cuff can be damaged:

Tears - the cuff can be torn by a fall or when lifting something heavy. You may experience sudden pain and weakness in the shoulder straight away, and be unable to fully lift the arm up sideways.
Impingement syndrome - this is caused by a partial tear of the rotator cuff, or by degeneration (wear and tear). As the arm is raised sideways, pain is experienced in the shoulder.

How can rotator cuff tears be treated?

Simple painkillers and restriction of activities may help reduce pain and problems. Steroid injections into the shoulder joint can also help with pain, but may only last a few months. Exercises and physiotherapy may also help to increase your shoulder strength and help reduce pain.

Larger tears may need surgery, which can be performed by either keyhole or 'open' techniques.

How is rotator cuff surgery performed?

Keyhole surgery - three or four small cuts are made around the shoulder, and special instruments are passed into the shoulder, together with a telescope. The surgeon can then shave off any excess bone, release any tight tissue and stitch any small tears.
Open surgery - this may be needed for a large tear of the rotator cuff. A cut is made across the front of the shoulder and the tear is stitched together with special stitches that fix into the bone.

What happens after the operation?

You will usually be able to go home the same day. Your specialist and physiotherapist will be able to guide you as to how much exercise you can do with the shoulder, and give you exercises to improve strength. You should check with your specialist and insurance company before starting to drive again. Whilst your shoulder will often give a good range of movement, it may never feel as good as a normal shoulder.

What are the risks of rotator cuff surgery?

Infection - this may need antibiotics or even further surgery to wash out the shoulder.
Damage to nerves - this is quite uncommon, but can lead to numbness or weakness in the arm.
Blood clots - clots in the axillary vein (armpit) can rarely occur. These can usually be treated with medication.
Stiffness - it is quite common to have a degree of stiffness in the shoulder, which can often be improved with physiotherapy. Occasionally, a short procedure may be needed to stretch the shoulder under anaesthesia to improve movement.