What is rotator cuff repair surgery?

Rotator cuff repair surgery is done to fix a tear in the rotator cuff. Your doctor may also clean the space between the rotator cuff tendons and the shoulder blade. This is called subacromial smoothing.

Your doctor will do either arthroscopic or open surgery.

With arthroscopic surgery, your doctor uses a lighted tube with a tiny camera. This tube is called an arthroscope. Your doctor puts it and other surgical tools through small cuts (incisions) in your shoulder. Most people go home the same day they have this surgery.

With open surgery, your doctor will make a 5 to 10 centimetre incision in your shoulder. Most people go home the same day they have this surgery.

In both surgeries, the scars usually fade with time. You will wear a sling for a few weeks.

You will need physical rehabilitation (rehab). At first, you will get help with the exercises. Later, your doctor or physiotherapist will give you exercises to do on your own. Rehab will last several months. It will take 3 to 4 months before you will be able to use your arm normally. It will take 4 to 6 months before you will be able to throw objects or play sports.

After surgery and rehab, you will probably have less pain and more strength in your shoulder. You should be able to lift and rotate your arm better. Some people have to avoid lifting heavy objects.

If you have a desk job, you will probably be able to return to work or your normal routine in 1 to 2 weeks. If you push, pull, or lift at work, you may be away from work for 3 to 4 months or longer. If you work at a job that involves heavy manual labour, lifting your arms above your head, or using heavy tools, you may have to think about finding other work.

What happens before surgery?

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• 
  Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• 
  Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• 
  Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 2 hours.

Going home

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  Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.