Rotator Cuff Repair

Rotator Cuff Repair

Shoulder rotator cuff consist of muscles which tendons are fixed to the greater and lesser tubercles of the humerus and surround the shoulder joint from three sides. These muscles help to stabilize a shoulder joint and enable its movements.

Tears of the rotator tendons (TRT) are one of the most common diseases of a shoulder joint. Studies demonstrated that TRT are commonly associated with age-related degenerative changes of the shoulder joint. Degenerative TRT in people below 40 years of age are diagnosed less often. The pathology is mainly associated with repeated physical overload and microtraumas (sports, heavy manual work with the arms raised up) rather than with the age-related changes alone. Traumatic tears of rotator cuff tendons can occur in people at different age.

About the surgery:

During the surgery the rotator cuff tendons are sutured at the anatomical site (anatomic reconstruction) and decompression of the subacromial space is carried out (the scary bursa is resected and the anterior part of the acromial process is flattened, the anterior osteophyte is removed and the coracoacromial ligament is released). The surgery results in improved function of a shoulder joint and disappearance of pre-operative symptoms. The majority of patients recover completely and can again enjoy sports, good sleep and continue moderate daily activities without limitations.

To whom this surgery is indicated?

A tear of the shoulder rotator cuff is diagnosed after clinical assessment of patient’s complains, medical history and results of special clinical tests. Data of instrumental examinations are assessed during a consultation and then an individual treatment method is selected. Tendon tear diagnosed by the instrumental examination is not an indication for a surgical treatment. The pathology should be consistent with examination findings and other clinical data (pain, disturbed function, muscle weakness, disturbed everyday activities).

Before the surgery:

The team of physicians in our clinic will carry out all necessary examinations and will assess general patients’ health condition. Aiming to ensure the best possible result, before the surgery you should follow physician's instructions.

During the surgery:

The surgery will be carried out under a general anaesthesia. During the surgery the tendons are sutured at the anatomical site (anatomic reconstruction) and decompression of the subacromial space is carried out (the scary bursa is resected and the anterior part of the acromial process is flattened, the anterior osteophyte is removed and the coracoacromial ligament is released). The surgery can be done applying mini-open or arthroscopic approach. The tendons can be suture using special suture anchor or standard sutures. Usually, the surgery lasts for about 2 hours.

After the surgery:

After the surgery the patient for several hours is transferred to an intensive care ward for observation, later the in-hospital treatment is continued. Usually on the next day after the surgery the patient is discharged.

On the next day after the surgery an early rehabilitation treatment is initiated: exercises of the elbow, wrist and hand joints. Exercise involving the passive movements of the affected shoulder can be initiated. The exercises of the early rehabilitation treatment should be continued for about 6 weeks. During this period the tendon gets integrated with the bone. Traction and active motion exercises are initiated after 6 weeks. Shoulder muscle strengthening exercises are initiated after 8 to10 weeks. 3 months after the surgery the patient is allowed to take part in moderate physical activities or perform manual work.