Open Shoulder Impingement and Rotator Cuff Repair Surgery

Learn more about shoulder impingement and rotator cuff repair at King Edward VII’s Hospital

Why would I need open shoulder impingement and rotator cuff repair surgery?

A shoulder impingent is a condition that causes pain in the shoulder, particularly when lifting the upper arm up towards and above the head.

The subacromial space is an anatomical space in the shoulder, under the acromion (part of your shoulder blade). This space can sometimes become narrowed due to various reasons casusing Subacromial Impingement. In this condition, the rotator cuff tendons can be inflamed and within the subacromial space can rub on the acromion or inflamed ligaments.

A shoulder impingement can be caused by injury, overuse of the shoulder such as in certain sports, bone spurs (bony growths of the acromion) as well as other conditions. It can lead to injury to the rotator cuff tendons causing pain and discomfort, as well as mobility problems.

Either due to impingement or an injury, the rotator cuff tendon may become torn. These tendons often do not heal by themselves. A rotator cuff tear can cause pain and weakness.

What symptoms does open shoulder impingement and rotator cuff repair surgery address?

Most patients requiring this kind of surgery need it because their shoulder pain has not been relieved by painkillers, steroid injections or physiotherapy.

It will help to relieve the pain and discomfort of a shoulder impingement and a rotator cuff tear, as well as help to improve movement within the shoulder.

When should you speak to your specialist about open shoulder impingement and rotator cuff repair surgery?

If you have shoulder pain and you have difficulty lifting your arm above your head without discomfort, speak to your specialist. They may perform some tests and scans and then discuss non-surgical and surgical options. You may be advised to proceed with shoulder impingement and rotator cuff repair surgery and your surgeon will discuss this in detail with you during your consultation.

How is open shoulder impingement and rotator cuff repair surgery performed?

Open shoulder impingement and rotator cuff repair surgery is performed under a general anaesthetic, meaning that you’ll be asleep throughout.

Unlike a rotator cuff repair which is often performed as keyhole surgery, an open shoulder impingement and rotator cuff repair is a larger operation, involving a surgical incision to the outer aspect of your shoulder, rather than small keyhole incisions. This allows greater access for your surgeon to repair more complex tears and if needed use graft material. The surgeon will explain the nature of this graft material and ask for your consent to use it, prior to surgery.

Your surgeon will then repair the damaged tendons and remove excess bone, widening the subacromial space within the shoulder to help prevent the same problem occurring again. Your wound will then be stitched or clipped together and dressed. You will awake from the surgery wearing a sling, which will be needed for 6 weeks.

What is the recovery like for open shoulder impingement and rotator cuff repair surgery?

Your recovery from open shoulder impingement and rotator cuff repair surgery will depend on multiple factors, including your age, fitness level and the nature of your procedure.

Most patients can return home the same day as their operation. You will be given advice from your nursing team on how best to recover and your physiotherapy team will provide you with exercises to carry out at home to aid your recovery.

You will need to take a few weeks of work and away from your normal day to day activities. However, it normally takes between three and six months to fully recover from this kind of surgery.

Are there any risks/complications associated with open shoulder impingement and rotator cuff repair surgery?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

Open shoulder impingement and rotator cuff repair surgery has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

• Bruising
• Bleeding within the shoulder
• Difficulty moving the shoulder and arm
• Pain and stiffness in the arm and hand
• Severe pain in the shoulder
• Blood clots
• Injury to the nerves
• COVID
• General anaesthetic and interscalene block (which will be discussed with you by your anaesthetist)
• Infection

How can I prepare for open shoulder impingement and rotator cuff repair surgery?

Prior to open shoulder impingement and rotator cuff repair surgery, your surgeon will discuss with you how best to prepare, as each patient is different with differing needs.

Common preparations for open shoulder impingement and rotator cuff repair surgery include:

• Routine blood tests, x rays or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise

Are there alternatives for open shoulder impingement and rotator cuff repair surgery?

Painkillers, steroid injections and physiotherapy exercises can all also help to relieve the pain and discomfort of a shoulder impingement and a rotator cuff tear.