Some photographs taken during rotator cuff repair surgery:
Tape Sutures (A) are passed through the tendon tissue (C) and brought
out of the shoulder through a plastic cannula (B) to be loaded onto an anchor
The completed Suture-Bridge tendon repair. The tendon is firmly snugged down against
the bone footprint of the humerus to optimise the chances of healing
This video shows a completed arthroscopic repair of a very large cuff tear. Note the overlapping sutures that provide stable compression of the repaired tendon onto the humeral footprint.
You will go home on the same day, or the morning after your operation. Please begin to take your prescribed painkillers before your nerve block wears off and continue to take them regularly for the first few days. You will need to wear a sling for four-to-six weeks to protect your tendon repair. Please take note of what movements are allowed and what to avoid. You can take down any bulky padded dressings on day 2 after surgery, but please keep your wounds covered with the waterproof dressings for 12 days. Showering is fine after four days. Any sutures can be removed at 12-14 days after surgery in the clinic.
Rehab Stages:
Phase 1 - Protection of your tendon repair in a sling. Restricted movements (4-6 weeks)
Phase 2 - Restore shoulder range of motion and control. (4-12 weeks)
Phase 3 - Strengthening and functional return (12-26 weeks)
Speed of recovery varies, but you can aim to return to:
Office work after two to four weeks if you are comfortable in a sling
Light work after twelve weeks
Heavy labour and sport may take 6 months
Driving is allowed once you are confident and competent to control a car both for routine and emergency manoeuvres. This will probably take 8 weeks or so.
By six weeks, many patients will be comfortable during normal daily activities, but certain movements will still be restricted. Do not worry if you remain sore at this point: it can take a while longer to recover from this operation. By six months, 85% of patients will feel their shoulder is better, although some patients take even longer to benefit.
Arthroscopic shoulder surgery is very safe, and major complications are rare. Specific risks of rotator cuff repair surgery include:
Failure of tendon healing -
The healing rate varies: most studies report healing rates of approx. 70%-90%. Healing is influenced by your age, your tendon tissue quality, the tear size and retraction and the repair itself
Failure to heal fully does not necessarily lead to a poor outcome, but as you would expect strength is better in those patients whose tendons heal fully. Some repaired tendons will re-tear in the future.
Stiffness /Frozen shoulder(3-5%) - this might necessitate injection or further keyhole surgery to free up movement (capsular release and MUA)
Lack of benefit - approximately 10% of patients will not feel they have improved with their surgery. It may take 6 months to feel you have made a good recovery from this operation.
The risks of nerve injury, deep infection and major bleeding are very low (much less than 1 in 100 chance)