Delayed or Secondary Shoulder Tendon Repair (Rotator Cuff Repair)

Learn more about rotator cuff repairs at King Edward VII’s Hospital

Why would I need this surgery?

The main tendons in the shoulder form the rotator cuff, a collection of four muscles and tendons that provide stability and movement to the shoulder. The rotator cuff attaches the upper arm to the shoulder blade and allows free movement of the arm, especially so when lifting the arm towards and above the head.

Certain sports such as tennis, overuse or injury can cause tears to the rotator cuff, causing pain and reduced mobility.

Rotator cuff repair surgery is an effective way of treating shoulder tendon damage but occasionally surgery fails to fix the repair. Delayed or secondary shoulder tendon repair surgery can then be effective. It’s also helpful when rotator cuff tears haven’t been repaired and are causing long term pain and mobility problems.

What symptoms does this surgery address?

Surgery is effective at relieving the pain of a rotator cuff injury and restoring freedom of movement to the shoulder and arm if treatment has been delayed or previous surgery hasn’t been effective.

When should you speak to your specialist about this surgery?

If you’ve previously had rotator cuff surgery but you still have shoulder pain after a year, or you’ve had shoulder pain or immobility for a long time without treatment, speak to your specialist.

They may perform some tests and scans and may then refer you for secondary shoulder tendon repair surgery.

How is this surgery performed?

Delayed or secondary shoulder tendon repair surgery is carried out as keyhole surgery and you’ll be asleep under a general anaesthetic throughout.

Your surgeon will make a number of small cuts in your shoulder, and use long, thin instruments to repair the tendon damage.

If the damage to your shoulder tendon is great, your surgeon may also surgically patch up the tendon tear using a part of a tendon from elsewhere in your body. They will discuss this with you beforehand, and may also discuss the possibility of a prosthesis, or artificial shoulder joint.

Your wounds will then be stitched and dressed. Most patients can return home the same day as this kind of surgery.

What is the recovery like for this surgery?

Your recovery from surgery will depend on multiple factors, including your age, fitness level and the nature of your procedure.

Your nursing team will give you advice from your surgeon on how best to aid your recovery and your physiotherapy team will provide you with some exercises to do at home. After around two weeks, your stiches can be removed.

It may take up to a year to fully recover your full range of movement but carrying out your exercises regularly will help significantly.

Are there any risks/complications associated with this surgery?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

Shoulder tendon repair surgery has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

• Bruising
• Bleeding within the shoulder
• Difficulty moving the shoulder and arm
• Pain and stiffness in the arm and hand
• Severe pain in the shoulder
• Blood clots
• Injury to the nerves
• Retear

How can I prepare for this surgery?

Prior to shoulder surgery, your surgeon will discuss with you how best to prepare, as each patient is different with differing needs.

Common preparations for surgery include:

• Routine blood tests, x rays or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise

Are there alternatives for this surgery?

You may be able to manage your pain and discomfort with painkillers, steroid injections and physiotherapy.