Rotator cuff repair surgery, as you would imagine, is not straightforward. Not only is every tear different so is every patient's anatomy, every doctor etc, etc.

Rotator cuff surgery thankfully does have specific aims to increase strength and decrease pain.In this section I want to show you how rotator cuff repair surgery can be used to achieve these goals.

Whatever rotator cuff repair technique your doctor chooses has to be right for you and just as importantly right for them too.This is so important to cut down on the rotator cuff surgery recovery time that you face.

In this section I want to focus on rotator cuff surgery for full thickness rotator cuff tears. I want to explain what you can expect during and after your rotator cuff surgery.

I have already discussed the three main rotator cuff repair technique options available to your surgeon. In the section headed "torn rotator cuff surgery" I described the open, mini open and arthroscopic options. In this section I want to focus upon what is actually done during rotator cuff repair surgery.

Rotator cuff repair surgery - preparation

Most rotator cuff surgery can now be carried out on an outpatient basis.

In other words you will not be required to stay overnight in hospital.

There may be occasions when the anticipated procedure is complicated by an unseen factor and you may have to remain in hospital after the operation.

If you are treated as an outpatient it is vital that you strictly follow any advice offered. Because every centre is different I don't want to provide a list of do's and don'ts.

It is likely that you will be told no eating after midnight and only a small amount of liquid in the morning. This really is for your safety, don't take any risks here it is all to do with safe use of anaesthetic.

Rotator cuff repair surgery - anesthesia

Rotator cuff surgery can be performed with a general anesthesia that knocks you out completely. It can also be performed with a regional or localised anesthesia.

A block is made into the nerves of the neck that make the arm go numb; this lasts approximately 12 to 16 hours. This is generally much better immediately after the rotator cuff surgery as it aids in initial pain relief.

If the surgery is to be carried out using a regional anesthesia you will almost certainly be given something to make you very drowsy. It helps to monitor your progress if you are not completely knocked out.

Arthroscopy - the best rotator cuff repair technique?

Surgeons appear to be moving towards the arthroscopic rotator cuff repair technique. The advantages of performing surgery this way are smaller incisions, less disturbance of the normal shoulder musculature, and most likely less pain following surgery.

The approach is less intrusive and does not require seperating muscle layers in the same way that the open approach does. As a result the pain caused by seperating the muscle layers is decreased.

The rotator cuff surgery recovery time remains the same. This is because it still takes the same amount of time for the tendon to heal back to the bone. But the advantages of arthroscopy are still significant.

I have therefore used the arthroscopic rotator cuff repair technique to show what is done during surgery. It is important to remember however that all the different aspects would be performed not matter the technique employed.

Rotator cuff repair surgery

So what actually happens during rotator cuff repair surgery? Well full thickness rotator cuff tears generally require a number of different steps to be completely successful. It is likely that all or most of the following will be a minimum. Your surgeon will

• 1. Inspect all the tissues of your shoulder joint and the area above the joint, the cartilage, bones, tendons, and ligaments.



• 2. Repair any damaged tissues. To do this, your surgeon will make a number of small incisions and insert other instruments through them. Damaged tissue may need to be removed.



• 3. Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures (stitches). Small rivets called suture anchors are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic and there are dissolvable sutures available. The sutures do not need to be removed after surgery.



• 4. Surgery for impingement syndrome or decompression surgery will be performed. Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. The bursa may be removed. Your surgeon may also shave off the under part of a bone called the acromion. This all creates more space for the rotator cuff to move in.



• 5. At the end of the surgery your incisions will be closed with stitches and covered with a dressing (bandage).



• 6. Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

The video clip above is one of the best I have seen at condensing all of this into an easy to follow format.