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Rotator Cuff Repair
Indications for operation:
Rotator cuff rupture

Anaesthetic:
General Anaesthetic with an interscalene block (Fully asleep with a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type:
If the rupture can be repaired through the arthroscope it will be.
Very large tears require an open operation

Incisions:
3-4 ½ cm incisions will be made in the shoulder, one to the back, one at the side and one at the front of the shoulder.

Procedure:
The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. A soft tissue shaving device will be used to clear any scar tissue away. A bone-shaving device will be used to shape the underside of the acromion (the bone at the top of the shoulder) and remove any excess bone.The edges of the cuff tear are tidied with the soft tissue shaver and sutures passed through the edge. The sutures are attached to small anchors (screws) in the bone and the cuff is reattached to the bone using these anchors.

Wound Closure:
Small butterfly paper stitches will be used to close the wounds.

Dressings:
Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare:
An adhesive dressing will be placed over the wound and the arm will be placed in a splint to keep the arm lifted away from your side. This splint must be worn for several weeks. You can go home when you feel comfortable and will be given instructions on what to do next.

Very Large Tears (Open operation)
Incisions:

A 5cm incision is made from the front outer edge of the acromion down the arm.

Procedure:
The procedure is similar to the other procedure. First the scar tissue is removed and the muscles of the rotator cuff are mobilized to close the defect before being sutured to the bone. It may not be possible to close the defect completely and other muscles may have to be moved to aid with the closure.

Wound Closure:
The wound will be closed with a single dissolving stitch running under the skin.

Dressings:
An adhesive dressing will be placed over the wound and the arm will be placed in a splint to keep the arm lifted away from your side. This splint must be worn for several weeks.

Immediate aftercare:
You can go home when you have been taught how to manage the splint. Further instructions will be provided.
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