ARTHROSCOPIC ROTATOR CUFF REPAIR MELBOURNE

Arthroscopic Rotator Cuff Repair Melbourne

A Patient’s Guide:

 Dr Christopher Pullen – BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

“I may recommend a arthroscopic rotator cuff repair if you have a painful condition that does not respond to nonsurgical treatment including rest, physical therapy, medications and injections.

Prior to recommending surgery, I will undertake a thorough clinical examination, discuss your diagnosis and detail the treatment options to ensure you understand the benefits and potential complications.”

PATIENT CARE PROCESS – DR CHRISTOPHER PULLEN
Dr Pullen’s approach to your care:

1. First Appointment

Referral, consultation & testing.

2. Diagnosis

Diagnosis & treatment options.

3. Treatment Plan

Non-operative VS operative.

4. Follow up & care plan

Monitoring, pain relief & care plan.

ROTATOR CUFF ANATOMY

The anatomy and function of your rotator cuff

Your shoulder is made up of three bones: (1) Humerus – the upper arm bone, (2) Scapula – the shoulder blade, and (3) Clavicle – the collarbone. The ball, or head, of the humerus fits into a shallow socket in the shoulder blade.

Your arm is kept in your shoulder socket by four rotator cuff muscles:

(1) Supraspinatus – Responsible for movement away from the centerline of your body (abduction).

(2) Infraspinatus – Is the main muscle responsible for external rotation of your arm away from the centerline of your body.

(3) Teres minor – Is a small, narrow muscle on the back of your shoulder blade just below infraspinatus. It also contributes to external rotation.

(4) Subscapularis – Is a large triangular muscle on the front of the shoulder blade responsible for internal rotation of your arm.

Bursa – The Bursa is a lubricating sac that sits between the rotator cuff and the bone on top of the shoulder and allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

Shoulder & Rotator Cuff Anatomy

Figure 1

ROTATOR CUFF TEARS

Rotator cuff tears are common, especially in people over 40, athletes, and people whose work involves repeatedly lifting their arms overhead.

In many cases, a tendon tear begins with simple fraying and as the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.

Most tears occur in the supraspinatus tendon, but other parts of the rotator cuff may also be involved.

The rotator cuff tendons are usually torn away from the bone.

There two different types of tears:

(1) Partial-thickness tear – This type of tear does not completely detach the tendon from the bone.

(2) Full-thickness tear – When a tendon is completely detached from the bone.

ARTHROSCOPIC ROTATOR CUFF SURGERY

The aim of an Arthroscopic Rotator Cuff repair is to reattach or repair the torn ligament/s. Most patients can expect a 6-12 month rehabilitation period.

On the morning of your surgery your anaesthetist will examine you and make sure you are fit to undergo an anaesthetic. He will explain the anaesthetic to you.

The operation takes approximately 1-2 hours and involves 4 or 5 very small incisions around the shoulder.

The acromion bone may be trimmed and the coraco-acromial ligament removed. Both these structures rub on the rotator cuff and may have contributed to the rotator cuff tear.

The rotator cuff is then inspected and the tear is repaired using suture anchors and stitches.

Arthroscopic Rotator Cuff Repair Melbourne

AFTER YOUR ARTHROSCOPIC ROTATOR CUFF SURGERY

What happens after surgery?

After the surgery you will wake up in recovery with your arm in a sling. Dr Pullen will see you to discuss the results of the surgery. Your shoulder will be swollen and painful and you will be given painkillers and an ice pack regime to help ease the pain.

Usually you will need to stay in hospital overnight. Most patients can go home the next day.

The next morning your bandages will be changed and a physiotherapist will see you and tell you which exercises and activities you may undertake to help your recovery. You can shower but must dry the wounds carefully.

Pain relief – It is normal to have pain after surgery and painkillers will be given to you during your hospital stay and to take home. Your pain will slowly reduce over time.

After your surgery – Do not attempt to lift or rotate the arm. The next day a physiotherapist will discuss a rehabilitation program with you. During the first 6 weeks after the operation it is important that the repaired muscles do not contract when the shoulder is moved as the repair may be torn apart. The rotator cuff muscle takes 6 weeks to heal to the bone.

An appointment will be organised for you to see Dr Pullen in 10 to 14 days after your surgery.

ARTHROSCOPIC ROTATOR CUFF REPAIR – RECOVERY TIMELINE

The recovery period varies from patient to patient and depends on the nature and complexity of the surgery. A typical recovery timeline may include:

Timeline – After surgeryDescription
6 to 8 weeksIt takes 6 to 8 weeks for the tendon to heal to the bone. It is important that the shoulder muscles do not contract during this time so to avoid tearing the repair. The goal is to reduce pain, optimise tissue healing and encourage passive shoulder movement.
8 to 12 weeksRestore shoulder movement to help regain mobility.
4 to 6 monthsIt usually takes between 4 to 6 months after surgery to achieve a significant end range strength, power, and endurance back into your shoulder.

Please contact my office or your general practitioner if after surgery you have:

  • Severe pain that is not helped by the pain medication you have been given
  • Redness or swelling around the wounds
  • Fever, sweats or chills.

POTENTIAL COMPLICATIONS

The surgery complications which may occur after a arthroscopic rotator cuff repair may include:

  • Shoulder stiffness and restricted movement
  • Infection
  • Numbness or tingling around the shoulder
  • Recurrent tendon tear.

Dr Pullen will discuss with you in detail the potential complications and risks in relation to the surgery.

Mr Troy Keith
Dr Christopher Pullen
BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

If you have any questions please contact my team:

 Arthroscopic Rotator Cuff Repair Melbourne:

Dr Christopher Pullen – Orthopaedic Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Proud member of Royal Australasian College of Surgeons and Australian Orthopaedic Association.

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Arthroscopic Rotator Cuff Repair Surgery Melbourne

Dr Pullen treats patients from all over Victoria in relation to shoulder injuries. He consults with patients at the following practice locations in Melbourne including East Melbourne and Ringwood.