Rotator Cuff Repair and Biceps Tenodesis Surgery

Rotator Cuff Repair and Biceps Tenodesis Surgery

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Patient Information Leaflet

Hospital Contact Information

• Sulis Hospital: 01761 422222
• Bath Clinic Circle Health Group: 01225 809343
• St Joseph’s Hospital: 01633 820344

Table of Contents

1. Introduction
2. Summary of Surgery and Recovery
3. Shoulder Anatomy
4. Shoulder Conditions
   • Rotator Cuff Tear
   • Long Head of Biceps (LHB) Tendon Rupture
5. Treatment Options
6. Surgical Details
   • Rotator Cuff Repair
   • Sub-Acromial Decompression
   • Acromioclavicular Joint Excision
   • LHB Tenotomy or Tenodesis
   • Irreparable Rotator Cuff Tears
7. Anaesthesia
8. Post-Surgery Considerations
   • Pain Management
   • Wound Care and Stitches
   • Sling Usage
   • Returning to Daily Activities
   • Driving, Work, and Sports
9. Rehabilitation and Physiotherapy
10. Post-Operative Exercises
11. Appendix

1. Introduction

This booklet explains the causes of shoulder pain and provides guidance for recovery following shoulder surgery. It is designed to complement the advice from your Orthopaedic Consultant and Physiotherapist.

2. Summary of Surgery and Recovery

• The shoulder relies heavily on stabilizing muscles (the rotator cuff). Tears can lead to pain and limited motion.
• Surgery involves stitching torn tendons and, in some cases, additional procedures.
• Recovery takes time, with a sling required for 3–6 weeks and full function expected within 9 months.

3. Shoulder Anatomy

• The glenohumeral joint (GHJ) is a ball-and-socket joint.
• Surrounding muscles and tendons, known as the rotator cuff, stabilize the joint.
• The subacromial space and bursa cushion the rotator cuff from surrounding bone structures.

4. Shoulder Conditions

Rotator Cuff Tear

• Causes: Trauma (e.g., falls) or age-related degeneration.
• Symptoms: Pain during movement, night pain, and difficulty lifting or rotating the arm.

Long Head of Biceps (LHB) Tendon Rupture

• Causes: Forceful actions or trauma.
• Symptoms: Sudden pain and audible "pop." Surgery is typically unnecessary.

5. Treatment Options

• Non-surgical treatments: Painkillers, physiotherapy, and injections.
• Surgical intervention: Required for traumatic full-thickness tears or if other treatments fail.

6. Surgical Details

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Rotator Cuff Repair

• Tendons are stitched to the humerus using sutures and anchors.
• Additional procedures may include sub-acromial decompression, ACJ excision, or LHB tenotomy/tenodesis.

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Irreparable Rotator Cuff Tears

• An Orthospace InSpace™ Balloon may be used to restore basic shoulder function.

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7. Anaesthesia

• A combination of a regional nerve block and light general anaesthetic is typically used.
• Regional nerve blocks provide pain relief for up to 24 hours post-surgery.

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8. Post-Surgery Considerations

Pain Management

• Prescribed analgesics (e.g., paracetamol, NSAIDs) and ice packs help manage pain.

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Wound Care

• Stitches are removed 10 days post-op; keep the wound dry until healed.

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Sling Usage

• Wear the sling for 3–6 weeks, removing it only for hygiene and exercises.

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Activity Restrictions

• Avoid lifting or active arm movements for the first 3–6 weeks.
• Use "Safe Zones" and the "Soreness Rules" to guide activity progression.

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9. Rehabilitation and Physiotherapy

• Initial exercises start after the nerve block wears off, with progression guided by a physiotherapist.
• Regular outpatient physiotherapy begins 2–3 weeks post-op.

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10. Post-Operative Exercises

Gentle Mobility Exercises (In Sling)

1. Neck stretches (forward, sideways, and rotations).
2. Shoulder blade rolls (forward and backward).
3. Elbow bends and wrist stretches.

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Specific Shoulder Exercises

1. Passive Forward Flexion: Lean forward to let the arm hang naturally.
2. Passive External Rotation: Gently guide the operated arm outward using the non-operated arm.

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11. Appendix

• Guidance Techniques: Use "Safe Zones," "Pacing," and "Soreness Rules."
• Key Reminders:
  • Watch for signs of infection (e.g., redness or fever).
  • Contact the hospital if pain worsens or you encounter difficulties.

For further information or concerns, contact your consultant’s medical secretary.

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