Rotator cuff repair of the shoulder open operation

If you are considering shoulder surgery to repair a rotator cuff injury, or have an operation planned, it is important to know all you can about it. This includes:

• why you need this operation

• what it will be like

• how it will affect you

• what risks are involved

• any alternatives.

The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your choices of treatment to repair a rotator cuff injury with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

What is the problem?

You have a painful shoulder. This is due to a tear or hole in the tendons at the top of your shoulder. The group of tendons are called the rotator cuff.

What is the rotator cuff?

The rotator cuff is the group of tendons over the top of the shoulder joint that make your arm move. The tendons are not separate from each other but are joined together to make a continuous sheet, called a cuff. They run under an arch of bone that is part of the shoulder blade. The rotator cuff is normally attached to the top of your upper arm bone (humerus).

What has gone wrong?

You have a tear or hole in your rotator cuff. This is probably as a result of the tendons rubbing against the arch of bone above. You also have pain when you use your arm. You may not be able to do certain things, such as lift your arm above shoulder height. The pain is not directly due to having the hole in your rotator cuff. It is unclear exactly where the pain comes from. Many older people have a tear or hole in the rotator cuff but do not have pain.

The aims

Our aim is to stop your shoulder hurting. After the initial pain from the operation the old pain from your shoulder will be better.

The benefits

The main benefit is to reduce the pain that you get from your shoulder. If your shoulder is weak, it may be stronger afterwards.

Are there any alternatives?

The tendon cannot repair itself. In some people, after many months, the pain can diminish without surgery. If your shoulder is weak, this will not improve and there is no satisfactory alternative treatment. 

What if you do nothing?

Your shoulder will usually continue to hurt and be weak.

Who should have it done?

If your shoulder is painful you should have the rotator cuff repair operation.

Who should not have it done?

If your shoulder does not hurt, then you should not have an operation. This is because there may be discomfort after the operation. You would then be worse off than before.  

Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma

© Dumas Ltd 2006

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