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Rotator Cuff Repair
Rotator cuff repair is a surgical procedure to mend tears in the rotator cuff, a group of tendons that stabilise and move the shoulder joint. It can be performed arthroscopically – a minimally invasive technique involving small incisions to insert a camera and specialised instruments. In cases of severe injuries, open surgery may be necessary. The primary goals of rotator cuff repair are to restore shoulder function, alleviate pain, and improve mobility.
Dr Dennis Ng Zhaowen
Indications for Rotator Cuff Repair
Rotator cuff repair is recommended when shoulder conditions cause significant dysfunction that cannot be managed through non-surgical treatments. Surgery is usually recommended in the following situations:
- Full-Thickness Rotator Cuff Tears: Complete detachment of the tendon from the bone, resulting in pain, weakness, and loss of shoulder function.
- Acute Traumatic Injuries: Sudden tears from trauma, such as falls or heavy lifting, that require surgical intervention to stabilise the joint.
- Degenerative Tears: Gradual wear-and-tear injuries that worsen over time, particularly when they lead to persistent pain or difficulty with routine tasks.
- Unresolved Pain and Weakness: When physical therapy and medications fail to alleviate symptoms, and the shoulder remains weak or painful.
- Severely Limited Mobility: Surgery may be necessary when restricted shoulder movement affects daily activities or work.
Benefits of Rotator Cuff Repair
Rotator cuff repair offers a range of outcomes that enhance function and reduce discomfort. Key benefits include:
- Pain Reduction - Surgical repair helps alleviate chronic shoulder pain, improving day-to-day comfort.
- Restored Strength - Repairing the tendon allows muscles to function properly, enabling the shoulder to regain strength and stability.
- Increased Mobility - Surgery improves shoulder movement, enabling patients to perform activities that were previously difficult or restricted.
- Prevention of Long-Term Damage - Timely repair reduces the risk of complications, such as tendon retraction or muscle atrophy, which could lead to further disability.
Preparing for Rotator Cuff Repair
Proper preparation ensures a smooth surgical experience and successful recovery. The key steps involved are:
- Medical Evaluation
A thorough review of medical history, current medications, and existing health conditions helps assess overall health and identify any risks. Certain medications, such as blood thinners, may need to be adjusted to minimise the chance of bleeding during surgery. - Imaging Tests
Imaging confirms the extent of the tear and guides the surgical approach. X-rays help identify bone abnormalities or spurs, while MRIs provide detailed visuals of soft tissues like tendons, revealing the size and severity of the tear. Ultrasound may also be used to assess tendon movement in real-time. - Medication Adjustments
Certain medications, such as blood thinners, may need to be adjusted or temporarily paused to reduce the risk of excessive bleeding. - Fasting
Fasting for 8 to 12 hours before surgery is usually required to ensure an empty stomach for anaesthesia and to prevent complications like aspiration.
Step-by-Step Procedure
Anaesthesia Administration
Depending on the surgical approach and patient needs, either general anaesthesia (full unconsciousness) or regional anaesthesia (numbing the shoulder area) will be used.
Surgical Procedure
Depending on the severity of the tear, the surgeon will perform either arthroscopic repair or open surgery, which involves a larger incision for direct access to the tendon. In both methods, the torn tendon is reattached to the bone using sutures or anchors to restore stability and function.
Completion and Incision Closure
After the tendons are repaired, the instruments are removed, and the incisions are closed with sutures or surgical tape. A sterile bandage is applied to protect the site and reduce the risk of infection.
Post-Surgical Care and Recovery
Proper post-operative care ensures effective healing and helps restore shoulder function after rotator cuff repair. Recovery is typically divided into the following phases:
Immediate Post-Operative Care
After surgery, vital signs are monitored until the anaesthesia wears off. Pain relief is managed with medications, and ice packs may be applied to reduce swelling. A sling is used to immobilise the shoulder and protect the repaired tendon. Before discharge, patients receive instructions on pain management, wound care, and activity restrictions.
Physical Therapy
Physical therapy typically begins 1 to 2 weeks after surgery, focusing on light range-of-motion exercises to prevent stiffness. Passive exercises may be used initially to protect the tendon, followed by strengthening exercises introduced as healing progresses. The intensity and frequency of exercises are adjusted to prevent strain on the shoulder while restoring function.
Long-Term Recovery
Heavy lifting, overhead activities, and strenuous movements should be avoided until the shoulder heals. Light tasks, such as desk work, can usually resume within 4 to 6 weeks, while physically demanding activities may take 3 to 6 months. Follow-up appointments help to monitor healing and adjust the recovery plan as needed. Any signs of complications, such as swelling, redness, fever, or increased pain, should be reported immediately to prevent further issues.
Potential Risks and Complications
While generally safe, rotator cuff repair carries risks such as infection, bleeding, blood clots, and nerve or vessel damage. Infections may require antibiotics, and severe bleeding may need further treatment. Blood clots can develop but are often prevented with early mobilisation. Nerve or vessel damage is rare but can cause numbness or circulation issues. In some cases, the tendon may not heal properly, or the tear could recur, requiring further surgery.
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Dr. Dennis Ng is dedicated to understanding your unique needs, focusing on restoring
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #08-41
Singapore 329563
Monday – Friday: 9am – 1pm; 2pm – 5pm
Saturday: 9am – 1pm
Sunday & PH: CLOSED
Other Clinic Location
Gleneagles Medical Center
6 Napier Road #07-15
Singapore 258499
Monday – Friday: 9am – 1pm; 2pm – 5pm
Saturday: 9am – 1pm
Sunday & PH: CLOSED
Frequently Asked Questions (FAQs)
What happens if I delay or avoid rotator cuff repair?
Delaying or avoiding surgery can lead to worsening symptoms, including increased pain and further tendon retraction. Over time, this may reduce the effectiveness of future treatment options, including surgery.
Can I undergo rotator cuff repair if I have other medical conditions?
Medical conditions such as diabetes or heart disease may require additional precautions, but they usually do not prevent surgery. A pre-operative evaluation ensures the procedure is performed safely.
Will I need to stay overnight in the hospital?
Rotator cuff repair is often performed as an outpatient procedure, meaning most patients go home the same day. However, some may require an overnight stay, especially after open surgery or if there are complications.
How long will I need to wear a sling?
A sling is typically worn for 4 to 6 weeks, depending on the extent of the repair and the surgeon’s instructions.