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ROTATOR CUFF REPAIR

Method
Arthroscopic or open repair of torn tendons of the rotator cuff
Duration
60 to 90 minutes
Recovery time
3 to 6 months

What is a rotator cuff repair?

The rotator cuff consists of four muscles whose tendons stabilise the shoulder joint and are responsible for its movement. A tear (rupture) – usually of the supraspinatus tendon – can lead to pain, loss of strength and restricted movement. The aim of the operation is to restore the continuity of the tendon and with it the function of the shoulder.

Depending on the extent of the damage, the repair is carried out arthroscopically (keyhole technique) or open. The tendon is reattached to the bone with special suture anchors. Where the tendon has retracted or the tissue is of poor quality, an additional tendon transfer or patch augmentation may be necessary.

Indications for a repair

  • An acute traumatic tendon rupture
  • Chronic tears with functional restriction
  • Pain syndromes with partial tears
  • An unsuccessful attempt at conservative treatment

How the operation proceeds

  • Operation under general anaesthetic, usually in the lateral or beach-chair position
  • Arthroscopic visualisation of the joint and the tendons
  • Removal of inflamed tissue and mobilisation of the tendon
  • Repair of the tendon with suture anchors at its original attachment
  • Subacromial decompression where there is impingement

Rehabilitation after a rotator cuff repair

Phase I (0-4 weeks): immobilisation and healing
  • Wearing a shoulder orthosis (for instance an abduction pillow)
  • Passive mobilisation exercises under guidance
  • No active lifting or loading of the shoulder
  • Cooling, pain medication, lymphatic drainage
Phase II (5-8 weeks): mobilisation
  • Beginning active-assisted exercises
  • Increasing the range of movement to about 90°
  • Strengthening the surrounding muscles
  • No overhead work and no jerky movements
Phase III (from week 9): functional build-up
  • Working towards a complete range of movement
  • Targeted build-up of the rotator cuff and the scapular stabilisers
  • Transfer to everyday life, sport-specific exercises
  • Full loading after about 4-6 months