Shoulder surgery (rotator cuff)

Rotator cuff surgery is a routine operation with a good success rate for most people.

However, for a minority the surgery may not work. We offer enhanced pre-assessment before your surgery and rehabilitation afterwards so we can help prevent this from happening.

All surgery carries some risk and side effects may include:

• Pain
• Bleeding
• Scarring
• Infection

In a small number of cases, side effects can develop after rotator cuff surgery, including:

• Nerve or blood vessel damage
• Stiffening of the joint
• Increased pain around the joint
• Small risk from the anaesthetic

For about 10 to 20% of people the surgery may not be successful. Poor aftercare and lack of proper rehabilitation can sometimes lead to the surgery not working.

At The London Clinic, we provide a range of rehabilitation options including access to highly trained physiotherapists who specialise in this type of care and state-of-the-art equipment such as our hydrotherapy pool.

Rotator cuff repair surgery is a treatment to resolve ongoing pain, weakness and discomfort in the shoulder joint.

This can be caused by damage to the tendons and muscles (rotator cuff) which attach your shoulder blade (scapula) to your upper arm bone (humerus).

Shoulder pain and weakness occurs when the rotator cuff is damaged due to an injury or general wear and tear.

There are two types of rotator cuff surgery: keyhole and mini-open surgery. Your surgeon will advise you which is more suitable for you to get the best results.

Rotator cuff surgery normally takes two to two and a half hours and may require an overnight stay.

Keyhole (arthroscopy) rotator cuff surgery

Keyhole rotator cuff surgery uses a small camera (arthroscopy) which is put inside your shoulder so your surgeon can assess the joint tissues.

1. First, your surgeon makes several tiny cuts (incisions) in the skin around your shoulder.
2. They then insert the camera through one of the incisions.
3. Next, your surgeon inserts specially designed instruments through a second incision, so they can repair any torn tendons or damaged tissue.

The incisions are closed with sticking plaster which keeps the edges together. A waterproof dressing is applied so you can shower more easily.

Keyhole surgery benefits include:

• Less pain after your operation
• No stitches
• It’s normally a same-day operation with no overnight stay required
• A quicker return to work and normal activities

Mini-open rotator cuff repair surgery

If you have a bigger tear or one of the rotator cuff tendons is totally detached, your surgeon may perform an open operation.

You might need open surgery if you need a bone block (graft bone onto the joint), you have bone spurs, or if the tissues are badly damaged.

With open surgery a small incision of 3 to 5cm is made in the skin so that your surgeon can easily access your joint.

Once complete, your surgeon removes the surgical instruments and closes your incisions with dissolvable stitches and applies a waterproof dressing to the wound.

You’ll then be taken to the recovery suite, until the anaesthetic wears off and your nurse is happy with your progress.

After surgery, you should find that you have less pain and stiffness in your shoulder and that you can move it much more easily.

Your quality of life should improve, as your ability to do normal activities returns.

At The London Clinic, the orthopaedic surgeons who offer rotator cuff repair surgery are world leaders in their field.

Your surgery will be performed in one of The London Clinic’s state-of-the-art operating theatres near Harley Street.

Depending on the type of surgery you have, you may need to stay with us overnight.

To make you feel more at home, we offer extra touches like a personalised food menu and concierge service.

Complementary therapies such as massage, reiki and acupuncture are also available upon request.

During your stay you’ll receive enhanced rehabilitation from a dedicated care team, which includes physical therapy and movement exercises.

You’ll also have a dedicated pain management nurse.

After surgery, you’ll be given a specialised sling which your physiotherapist will show you how to put on and take off.

Proper rehabilitation is a crucial part of recovery after rotator cuff surgery.

At The London Clinic, your highly skilled physiotherapist will be on hand to help you with any exercises to do at home, which will speed up your recovery.

Once at home, your personal care team will give you ongoing support to make sure you’re happy and everything is going smoothly.

How long it takes to recover from rotator cuff repair surgery depends on your age, the condition of your shoulder, and how fit and healthy you are before surgery.

Most people take up to six weeks to recover from the surgery and need to do specific rehabilitation exercises for up to nine months.

For the first few weeks your shoulder will be quite bruised and swollen. You’ll need to wear a specialised sling to protect your shoulder to help it heal.

Your physiotherapist will show you how to put the sling on and take it off correctly, so that you can wash and do your daily exercises.

Daily exercises are an important part of your recovery and your physiotherapist will guide you through these from the day you have your surgery.

You’ll need to practice the exercises two to four times each day for around six weeks and then intermittently for up to nine months until the shoulder stabilises.

For the first three months avoid putting pressure through your arm as much as possible.

You may need help with doing simple tasks like pouring a kettle.

More strenuous activities like running and swimming are normally okay two to three months after surgery.

Your physiotherapist and care team will always be on hand to help and if there’s anything you’re worried about, you can contact them at any time.