Orthopaedic Treatment FAQ

Rotator cuff tears are one of the most common causes of shoulder pain in middle-aged and older people. They can: happen suddenly because of a traumatic fall or fracture or from lifting heavy things awkwardly develop over time due to repetitive overhead lifting, decreased blood flow to your shoulder, or the abrasive impact of bone spurs If your job or sport includes lots of overhead lifting, you may be particularly prone to rotator cuff tears.

Not necessarily. Your treatment options are determined by the severity and duration of the problem. Non-surgical treats include rest, wearing a sling, injecting cortisone and an analgesic to reduce inflammation and manage pain, and physiotherapy. Surgical treatments include Arthroscopic rotator cuff repair via a small keyhole incision. This minimally invasive procedure usually involves an overnight stay in hospital. Most patients recover fully in around six to nine months. Reverse total shoulder replacement, a form of open surgery to repair massive or irreparable tears. Patients needing this type of operation often have arthritis as well as a rotator cuff tear. Arthroscopy and debridement (essentially a clean-up operation). Muscle transfers for an irreparable rotator cuff tear. Based on a diagnosis informed by physical examination, X-rays, and magnetic resonance imaging (MRI), I'll advise you on your most appropriate treatment options.

Where surgery is not contraindicated, I would consider surgical options for acute tears that threaten the health of otherwise strong tendons or chronic tears that don't respond to non-surgical treatment.

An untreated rotator cuff tear can become very painful. It can also undermine shoulder strength and mobility and significantly restrict your activities. If the tear needs surgical repair, you'll need to weigh up the pros and cons of having an operation.

Stiffness and reduced mobility after rotator cuff repair can happen where your body reacts to the surgery by producing scar tissue. When this happens, we recommend treating post-operative stiffness with physiotherapy and injections.

Lots of things will influence the speed of your recovery. Besides the complexity of your tear, age, fitness, and dedication to your rehabilitation program all play a role. After rotator cuff surgery, the average recovery time for resuming most of your daily activities is around six months. To put this recovery time in perspective, rotator cuff tears happen to muscles and tendons attached to your complex and highly mobile shoulder joint. Repairing them can involve stitching torn tissue back to the bone. All going well, you'll feel incremental improvements in shoulder strength and mobility for up to two years after your operation.

It depends. If you don't have significant damage to surrounding soft tissue and haven't fractured any bones, you may not need surgery to reposition your shoulder. An examination including an x-ray and possibly an MRI scan will help determine the extent of the injury to bone and soft tissue. Once we have this information, we'll advise you on the most appropriate treatment.

Recurring dislocations, despite non-surgical treatment, can signify a significant loss of strength and stability in your shoulder. A full examination and a frank discussion about lifestyle and sporting activities that may be putting you at risk will help answer this question.

All surgery to repair shoulder tissues is done under general anaesthetic. Arthroscopic or keyhole surgery can repair torn tendons and ligaments or tighten stretched ones. Repairing the soft tissues that hold your shoulder joint in place can prevent further dislocations. Arthroscopy is generally day surgery, so you're unlikely to need to stay in hospital overnight. You'll be prescribed pain relief, and you'll need to immobilise your arm and shoulder in a sling for around four to six weeks. Open shoulder surgery may be needed if the damage to your shoulder can't be repaired arthroscopically. Unlike keyhole surgery which needs one or several tiny cuts, open surgery requires a single incision above your shoulder joint. Open surgery allows for bones to be repaired as well as tendons and ligaments. Latarjet is a common surgical procedure to stabilise your shoulder and prevent further dislocation. A bone graft from the front of the shoulder blade is placed in the socket to stop your shoulder from popping out. Furthermore, the tendon attached to the grafted bone works like a sling to help hold your shoulder in place. Everyone recovers at their own rate. Generally, though, a full recovery from arthroscopic or open shoulder surgery takes around six months.

Frozen shoulder describes several conditions where the primary symptoms are stiffness, a reduced range of motion, and a feeling that something is "stuck." While your shoulder might feel OK when it's resting, sudden or specific movements might be painful.

Sometimes your frozen shoulder will fix itself over time with the help of rest, physiotherapy, and hydrodilatation injections. Hydrodilatation can be very painful and is often performed under anaesthesia or combined with manipulation under anaesthesia. If your frozen shoulder is linked to arthritis or dislocation, you may need surgery to help correct manage or correct these underpinning problems.

Hydrodilatation reduces pain for around 90% of patients and increases movement in around 70% of cases. These improvements can happen immediately or over several weeks. If it doesn't work for you, we can discuss surgical options or the possibility of manipulating your shoulder under anaesthetic.

In most cases, frozen shoulder will not reoccur in the same shoulder. Once the problem's resolved, the shoulder joint usually functions normally. Most people regain full flexibility and strength with no long-term shoulder issues.

A torn bicep will generally swell and looked bruised. Depending on the site of a tear, you'll probably feel pain in your elbow or shoulder and have difficulty lifting with the affected arm. Your bicep can hurt for lots of reasons, including after a single incident or a session of heavy lifting, or an intense racquet game. If pain and symptoms worsen after several days of rest, ice and compression, you may well have a tear.

Torn tendons don't usually heal by themselves. Strained or stretched ones can respond to non-surgical treatments such as anti-inflammatory medication, rest, elevation, ice, and compression. If you've torn your bicep due to a traumatic injury or strenuous and repetitive activity, you may need surgery to reattach the tendon at the shoulder or elbow. Although most shoulder biceps tears can be managed without surgery, most elbow biceps tears need surgery to avoid losing a significant amount of strength in the elbow. We diagnose bicep tears by physical examination. Sometimes an MRI scan may be required.

Most patients need four to six months to recover from biceps surgery. You'll need to immobilise your arm during some of this time to protect it while it heals. Depending on the rate of healing, you may be able to start gentle rehabilitation after several weeks. It can take up to six months for you to regain the strength and mobility you had before your injury.