Open Rotator cuff repair has become a very unusual operation in the Upper Limb Centre as nearly all repairs are now done by an arthroscopic technique. In the first stage of an open rotator cuff repair, the surgeon performs an arthroscopy to confirm the tendons are torn and to ensure repair is possible. The surgeon performs a Subacromial Decompression to remove any bone pressing on the shoulder rotator cuff tendons. This frees the repair from irritation and allows the tendons to heal and recover. The operation is initially performed as a key-hole technique. Repair of the tendons is performed through a 5-6cms incision on the side of the shoulder. The rotator cuff tendons are repaired back to the humerus with several strong stitches. Open repair takes about 2 hours to perform. The patient is given a general anaesthetic. An injection of local anaesthetic is normally given into the lower neck to anaesthetise the arm, which lasts for about 8 hours following the operation. This keeps the patient very comfortable through their early recovery. Two doses of antibiotics are normally given in the hours following the operation.
The patient wakes up in a sling in the theatre recovery unit. They are then transferred back to the ward. Most surgery is performed as an over night stay. The patient cannot start using the arm straight away. The repair must be protected in a sling usually for about 4 weeks. Physiotherapy however is started early with the first sessions given before the patient goes home. Passive range of movement exercises as started as soon as the patient can tolerate it. The physiotherapist lifts the arm to a range of movement advised by the surgeon. This varies between patients. Your physiotherapist will advise you on what you can do and give you a personalised routine of exercises. After 4 weeks active assisted and then full active movements are started. You will normally be off work for between 3 and 4 months. Patients doing heavy manual work may take longer.
