The rotator cuff is a group of muscles and their tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in the shoulder joint and help the shoulder move in different directions. The tendons in the rotator cuff can tear when they are overused or injured.
You will likely receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.
During the procedure, the surgeon:
- Inserts the arthroscope into your shoulder through a small incision. The scope is connected to a video monitor in the operating room.
- Inspects all the tissues of your shoulder joint and the area above the joint. These tissues include the cartilage, bones, tendons, and ligaments.
- Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage is fixed. Any damaged tissue is removed.
Your surgeon may do one or more of these procedures during your operation:
Rotator cuff repair:
- The edges of the tendon are brought together. The tendon is attached to the bone with sutures.
- Small rivets (called suture anchors) are often used to help attach the tendon to the bone.
- The anchors can be made of metal or plastic. They do not need to be removed after surgery.
Surgery for impingement syndrome:
- Damaged or inflamed tissue is cleaned out in the area above the shoulder joint.
- A ligament, called the coracoacromial ligament may be cut.
- The underside of a bone called the acromion may be shaved. A bony growth (spur) on the underside of the acromion often causes impingement syndrome. The spur can cause inflammation and pain in your shoulder.
Surgery for shoulder instability:
- If you have a torn labrum, the surgeon will repair it. The labrum is the cartilage that lines the rim of the shoulder joint.
- Ligaments that attach to this area will also be repaired.
- The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint.
- A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.
At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and the repairs that were made.
Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues.