Rotator Cuff Repair
The shoulder joint is the most moveable in the body, relying heavily on ligaments and muscles for its stability. The rotator cuff muscles stabilise the head of the humerus (upper arm bone) giving the shoulder strength, flexibility and control. Due to the formation of bony spurs under the acromion (part of the shoulder blade), tendons and other structures can be caught and become torn.
The initial part of the procedure may be done arthroscopically through small tubes. The surgeon removes any loose fragments of tendon or other debris from the damaged cuff tendon in the joint. This procedure, called debridement, helps the surgeon inspect tissue damage in the joint and determine the need for more surgery.
If there are bone spurs on the bottom of the acromion, the surgeon will use a rasp-like tool to smooth the area. This is called subacromial decompression or smoothing and will keep the acromion from pinching down on the supraspinatus tendon.
If no tear is found in the rotator cuff area, the procedure may end here.
If a rotator cuff tendon is torn, repair is based on the size and severity of the tear. Small to moderate tears may be repaired arthroscopically, but very occasionally open surgery may be needed if the tears are large. The torn end of the tendon is cleaned up and an area on the humerus is cleared.
The surgeon drills one or more small holes in the bone. This is either done with a drill or other sharp tool. Anchors are then placed in the holes which hold the stitches in place.
The tear in the tendon is stitched together. When the sutures are pulled tight to the anchors, the tendon reattaches to the humerus.
Following surgery the arm is usually placed in a sling. Physiotherapy will be required for full range of motion to be regained and shoulder strength increased. Over time the tendon will naturally reattach itself to the humerus bone.