Rotator Cuff Repair Surgery Overview

Rotator cuff repair surgery is a procedure aimed at restoring function and alleviating pain in individuals suffering from rotator cuff tears. This surgery can be performed using an open approach or arthroscopically, depending on the severity of the tear and the specific circumstances of the patient. During the procedure, the surgeon reattaches the torn tendons to the humeral head, ensuring proper alignment and stability. Post-operative rehabilitation is crucial for regaining strength and mobility, as it involves a structured programme of physical therapy tailored to each individual's needs. Successful recovery often leads to significant improvements in shoulder function and overall quality of life.

a 3D illustration of a rotator cuff repair surgery being performed with the Arthrex® SpeedBridge™, a surgical technique system that combines fully threaded SwiveLock® anchors with FiberTape® suture.

Step-by-Step Breakdown of Rotator Cuff Repair Surgery

  1. Preoperative Assessment

    • Conduct a thorough evaluation of the patient's medical history and physical examination.

      Review imaging studies (MRI or ultrasound) to assess the extent of the rotator cuff injury.

      Obtain informed consent from the patient.

  2. Anesthesia Administration

    • Administer general anaesthesia or regional anaesthesia (interscalene block) to ensure comfort during the procedure.

  3. Positioning the Patient

    • Position the patient in a semi-seated or lateral decubitus position to provide optimal access to the shoulder.

  4. Incision

    • Make an incision on the shoulder, either through an open approach or using arthroscopic techniques, depending on the severity and type of tear.

  5. Identification of the Rotator Cuff

    • Carefully dissect through the subcutaneous tissues to expose the deltoid muscle and the underlying rotator cuff tendons.

  6. Assessment of the Tear

    • Inspect the rotator cuff tendon for the size and quality of the tear.

    • Evaluate the surrounding structures, including the biceps tendon and other soft tissues.

  7. Debridement (if necessary)

    • Remove any degenerated or damaged tissue from the tendon edges and surrounding structures to promote healing.

  8. Preparation of Tendon and Bone

    • Prepare the edges of the torn tendon to create a healthy surface for repair.

    • Clean the footprint area on the humeral head where the tendon will be reattached.

  9. Suture Anchor Placement

    • Insert suture anchors into the bone at the prepared footprint.

    • These anchors provide a secure point for the sutures used to attach the tendon.

  10. Tendon Reattachment

    • Using sutures, carefully attach the tendon to the bone via the anchors. This may involve multiple anchors depending on the tear size.

    • Ensure the tendon is well-tensioned without excessive tension that could compromise blood flow.

  11. Closure of the Shoulder

    • Once the tendon is securely reattached, close the underlying layers carefully.

    • Suture the skin incision using appropriate techniques for cosmetic results.

  12. Postoperative Care

    • Apply a sling or immobiliser to support the shoulder and facilitate healing.

    • Provide instructions for pain management and activity restrictions.

    • Schedule follow-up visits to monitor recovery and initiate physical therapy as appropriate.

  13. Rehabilitation

    • Start a structured rehabilitation program that gradually increases range of motion and strength based on the patient's progress.

This surgical procedure typically takes about 1 to 2 hours, depending on the complexity of the rotator cuff injury and any concurrent procedures that may be necessary. This straightforward outline covers the fundamental steps in rotator cuff repair surgery. Each case may require specific adjustments based on individual circumstances.