Repair of the Rotator Cuff

This leaflet will advise you about the rotator cuff procedure and outline the recovery of your shoulder following surgery. 

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Why do I need this operation? 

The rotator cuff is a group of tendons that wrap around the shoulder joint. These tendons help to keep the ball part of the shoulder joint centred on socket. These tendons wear out and then tear spontaneously which can be worsened by a heavy fall or blow to shoulder. These tears can lead to pain with loss of movement and function. 

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The operation 

The aim of the operation is to repair the torn tendon. Most repairs are performed via key-hole surgery however some may be performed as an open procedure. The operation will involve removing degenerative tissue and bringing the tendon back to its original insertion on the head of the humerus (the ball part of the socket). The tendon is held in place with anchors. Anchors are used to hold the tendon in place while it heals these are small hard pellets (usually plastic) with tails of strong suture material that are fired into the bone in the humeral head. The suture tails are passed through the tendon and then tied down. The operation will also involve removing some bone from the underside of the bony arch (acromion) which is positioned just above the rotator cuff tendons known as a subacromial decompression. This prevents the bony arch from rubbing on the tendons and repair when the shoulder is moving. Your surgeon may combine the procedure with removal of the biceps tendon from the shoulder or removal of the joint between the collar bone and shoulder-blade. 

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Potential complications 

Unfortunately any operation has a chance of having a complication. Fortunately the chance of having a complication is small (<5%) and having a significant complication that will have a negative effect on the outcome of surgery is even smaller (<1%). The following are specific complications associated with a rotator cuff repair: 

Re-tear of the rotator cuff tendon - this is probably the most common complication with this procedure. Even with an excellent surgical repair the tendon remains degenerative and does not have the same strength as a virgin tendon. The larger the tear and gap between the torn tendon edge and bone, the greater the chance of it re-tearing. However, even if your tendon does re-tear you will gain benefit from the operation as your shoulder will be much less painful although you may not regain all your strength. It is unusual for patients to require a further operation. 

Stiffness this happens in the majority of patients to a greater or lesser extent but usually does not slow recovery. You should regain a full functional range of movement between 3 and 6 months after surgery. Sometimes stiffness can be severe and associated with pain, and take up to a year to resolve this is called a "frozen shoulder". 

Infection superficial wound infections are more common and can often be treated with a short course of antibiotics. Deep infections within the joint are rare but would require you to come into hospital to have the shoulder washed out and go on intravenous antibiotics 

Nerve injury this is unlikely to occur as the ports made for the keyhole surgery are place away from the known position of nerves. Sometimes nerves can get compressed or squashed during surgery which will present will numbness and weakness but this is likely to resolve within a few weeks. 

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The shoulder joint after surgery 

Length of hospital stay: Normally done as a day case 

Arm immobilisation: 4-6 weeks in a brace (see image) 

Total recovery period: 6-12 months 

Return to driving: 6-8 weeks 

Return to work: Desk based job - 4 weeks Manual job - from 3 months 

Return to sports: Non-contact from 3 months Contact/overhead from 6 months

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