rotator cuff disease risk factors

UK Study Identifies Risk Factors That Increase Need for Shoulder Surgery

Rotator cuff disease, or trauma to the rotator cuff, is a common complaint and can be caused by an injury, overuse whether due to sporting endeavour or employment, or can occur without any obvious cause.

A new study has helped to identify risk factors that increase the need for shoulder surgery as a result of rotator cuff disease. The population-based cohort study is one of the largest of its kind. Here, we’ll look at what it revealed, and you’ll discover more about rotator cuff injuries.

Understanding the new study

The recent large-scale study included data from 421,894 patients, with 47% being male. Participants were aged between 40-69 and the UK’s Biobank was used for the research. NHS inpatient records were used to identify patients who had undergone surgery for rotator cuff disease.

Hazard ratios were calculated using Multivariate Cox proportional hazards regression. The main risk factors discovered were sex, age, race, BMI, smoking, occupational demands and the Townsend deprivation index.

Interestingly, the study found that every additional 10 years of age contributed to a 55% increase in surgery rates for rotator cuff disease. A high BMI, non-white races and a lower deprivation score also contributed to an increased risk of surgery.

The majority of the risks identified are known to be modifiable. This means the risks can be reduced through healthier lifestyle choices.

The link between depression and rotator cuff tears

Although this new study is one of the largest of its kind, there have been previous smaller studies carried out that are worth referencing. In 2019, a study looked into the link between depression and rotator cuff tears and it produced some surprising results.

Depressive disorders are known to be associated with chronic systemic inflammation. Depression, for example, is associated with chronic diseases such as coronary artery disease and chronic obstructive pulmonary disease. So, how does this link to rotator cuff tears?

Although the underlying mechanism of how depression is associated with rotator cuff tears remains uncertain, it’s thought that inflammation not only plays a role in the onset of tendon injury but also then negatively impacts repair of injured tendons. Furthermore, depression could heighten the sensation of pain associated with rotator cuff disease in those patients suffering from depression.

Further research is needed to determine exactly how the two conditions are associated. However, the evidence so far does support they are connected. Patients with depression are more likely to require surgery for a rotator cuff tear than those without the mental health condition.

What is a rotator cuff tear?

The rotator cuff of the shoulder consists of numerous muscles and tendons which cushion the shoulder joint. It is responsible for keeping the upper arm bone within the shoulder socket. A tear can occur in any of the muscles or tendons surrounding the joint.

Usually, rotator cuff tears are caused by overuse or repetitive motions. However, they can occur as a single injury. They vary in severity and in some cases, surgery may be the only way to repair the injury.

While surgery can be an effective solution to the pain and lack of mobility associated with a rotator cuff tear, there are always risks associated with surgery that need to be considered. The new study suggests that healthier lifestyle choices may reduce the need for surgery. If you suspect you have rotator cuff disease, call 0203 195 2442 to arrange a consultation with the London Shoulder Specialists.

rehab after shoulder replacement

NICE Recommend Rehab Same Day as Shoulder Replacement Surgery

The National Institute for Health and Care Excellence (NICE) that provides guidance, advice and information services for health professionals, has issued new advice for patients undergoing a hip, knee or shoulder replacement. After undergoing surgery, patients should now attend rehab on the same day. This should be provided by an occupational therapist or physiotherapist.

Here, we’ll look at why the new guidance has been supplied and what shoulder replacement surgery involves.

Why is same day rehab recommended?

The new guidelines have been introduced after NICE consulted with the Association of Trauma and Orthopaedic Chartered Physiotherapists (ATOCP). It is known that early rehab can lead to much better outcomes for patients who have undergone joint replacement surgery.

Shoulder replacement surgery can result in a long and painful recovery. So, if patients can minimise the pain and discomfort through same day rehab, it’s a welcome change to the guidelines.

The only potential issue that could cause debate amongst the sector, is that in the small print, initial intervention could be carried out by any member of a therapy team provided they are qualified. Many experts claim the initial rehab should only be carried out by a physiotherapist or occupational therapist.

What does it involve?

The new guidelines mean that patients who undergo shoulder replacement surgery should receive the following rehabilitation therapy:

  • Advice on how to manage daily activities
  • Home exercise programme
  • Ambulation

The guidelines have been designed to be vague enough for clinicians to use their own expertise to decide upon appropriate care for each patient.

Understanding shoulder replacement surgery

Shoulder replacement surgery is carried out to treat a damaged or worn away shoulder joint. This typically occurs due to injury or shoulder arthritis. Either part, or all of the joint will be replaced using artificial parts.

There are different types of shoulder replacement surgery you can undergo. These include reverse, total and partial shoulder replacement. The reverse shoulder replacement tends to be the most common technique used. The standard total shoulder replacement remains the most common. This includes a metal ball being attached to the shoulder blade where the socket was. Then, a new socket is attached to the top of the arm, where the ball was. It basically switches the ball and socket around.

A total shoulder replacement surgery is also common. This technique replaces the ball and socket, but it keeps them in the same position. A partial replacement focuses on just replacing the ball of the shoulder.

Each surgery is designed to help patients improve shoulder motion and eliminate pain. The primary aim is to alleviate pain and hopefully also gain more function and movement The artificial parts used are typically made from metal, plastic, or a mixture of both materials.

Most patients who undergo shoulder replacement surgery are aged 70 or over. Most replacement joints will last at least 10 years before another procedure is required. There is a 10% failure rate at 7 years

The new guidelines issued by NICE ensure patients have the best chance of recovery. Being able to improve results by offering early rehab is going to prove welcome news to both patients and shoulder specialists.

If you think you might need a shoulder replacement, book a consultation with the London Shoulder Specialists today. The earlier treatment is sought, the better the outcome will be.

rotator cuff repair review

Rotator Cuff Repair Reviewed

Published last year in the Annals of the Royal College of Surgeons and now available to the public, is an in-depth analysis of research conducted in the field of rotator cuff repair titled. ‘Degenerative rotator cuff tear, repair or not repair? A review of current evidence’. The goal was to address whether a surgical or non-surgical approach would be better for patients. Among the study’s authors were three members of the London Shoulder Specialists; Mr Ali Narvani, Mr Steven Corbett and Mr Andrew Wallace.

Here, we’ll review the evidence that was revealed and what it means for those suffering from a rotator cuff tear.

Clinical outcomes for non-surgical repairs

In our analysis of research relating to clinical outcomes for non-surgical repairs, we found results were dependent upon the severity of the tear. The review focused on a multicentre study which included 452 patients who had atraumatic rotator cuff tears. They were treated with physiotherapy and reviewed at 6 and 12 weeks. Significant improvements were identified at both the 6- and 12-week review, although after two years, 26% of patients chose to undergo surgery.

It appears non-surgical treatment provides great early results, but patients still often go on to need surgery. Those with large and severe rotator cuff tears experienced the fewest benefits of non-operative treatment. In fact, for older patients with massive tears, the problem simply became worse over time. This is particularly true for patients with tears that affected three or more tendons.

Clinical outcomes for surgical repairs

A lot of studies have been carried out to determine the effectiveness of surgical rotator cuff repair. In one study which involved data from 1600 patients, it showed after six months there was a significant improvement in most patients in overhead motion and pain.

Another looked at surgical repair of full thickness tears. A total of 263 shoulders were included in the study. After five years, 94% of patients didn’t require any further surgery. Most impressively, after 10 years 83% of patients still didn’t require additional surgery.

So, surgical repair does appear to be more effective in the long term. However, it did take six months for patients to experience full improvements. This is slightly longer than the initial outcome for non-surgical treatment.

The role of age in rotator cuff repair results

There were conflicting results in the studies regarding whether age played a role in results. It is widely believed that age does impact the outcome of rotator cuff repair. However, some studies showed that there were no differences between the results experienced in younger age groups and those in older groups.

The only exception here is tendon healing. Evidence suggests that older patients do appear to take longer to heal when tendons are damaged. However, for most rotator cuff repairs, surgery had the same success rate in older patients as it did in younger ones.

The findings of the review confirm that rotator cuff repair surgery does tend to be the best option for patients. However, it does depend upon the size and severity of the tear. For patients experiencing a mild tear, physiotherapy and a non-surgical approach can be effective. However, for more severe and larger tears, surgery is the most effective option.

During the current COVID-19 crisis, all non-urgent / elective surgery bookings and appointments are postponed. These are now restarting though there are some restrictions in a quickly-changing landscape, but the London Shoulder Specialists are still available for consultation if you require more advice on rotator cuff repair. Consultations can be carried out either by telephone or video link and can be arranged by emailing appointments@fortiusclinic.com or by calling 020 3195 2442.

Calcific Tendonitis Treatment

New Study Finds Calcific Tendonitis in the Shoulder Can Predict Rotator Cuff Tears

A new study published within the Arthroscopy journal, has revealed calcific tendonitis in the shoulder could predict a rotator cuff tear. Researchers were trying to determine whether calcific tendonitis could protect the shoulder from a rotator cuff tear, or whether it was an indicator of the condition.

Here, we’ll look at what the latest study revealed and the link between calcific tendonitis rotator cuff tears.

The results of the study

The new study analysed 318 shoulders which had calcific tendonitis. Researchers looked at the charts of the patients from a single clinic dating from January 2010 to April 2017.

MRI and anteroposterior radiographic studies were reviewed by a radiologist. They looked for the size, morphology and the distance calcific tendonitis was away from the rotator cuff insertion. They also looked for any signs of a rotator cuff tear. A second radiologist then confirmed the results.

It was discovered that 56% of calcific tendonitis cases in the shoulder also had a rotator cuff tear. Out of the 177 rotator cuff tears, 164 of them were partial thickness tears, while 13 were total thickness tears. It was determined that rotator cuff tears associated with calcific tendonitis had an odds ratio of 1.8.

What is calcific tendonitis?

Calcific tendonitis is the build-up of hydroxyapatite on the tendons surrounding the rotator cuff. It tends to be much more common in women than it does men and tends to affect those aged between 30 and 60 years of age.

The condition can cause intense pain around the shoulder which can either be long-lasting or intermittent. This is caused by the body’s inflammatory response to the reabsorption of calcification. The cause of the condition isn’t known, though there is an increased risk for those who have Diabetes and thyroid gland dysfunction.

Sometimes, the condition can cause it to feel like the shoulder is catching. This is a very similar sign of shoulder impingement, making it sometimes difficult to diagnose first time around.

Understanding rotator cuff tears

Out of all shoulder injuries, rotator cuff tears are the most common. It can have a significant impact on your daily life and prove to be extremely painful. They are largely caused by degeneration of the tendon and muscles associated with age. However, they can also occur due to injury caused by an accident or trauma.

Signs of a rotator cuff tear include a stabbing or dragging pain within the shoulder. The pain tends to worsen at night, making it difficult for the patient to sleep. Moving the arm to the side or forwards will be extremely difficult and it will have a significant impact on the quality of life.

If you are experiencing shoulder pain, it is important to get the problem looked at as soon as possible. The longer a shoulder injury is left untreated, the worse it becomes. If you suspect you may have calcific tendonitis or a rotator cuff tear, book a consultation with a shoulder specialist to receive an accurate diagnosis.

During the current COVID-19 crisis, all non-urgent / elective surgery bookings and appointments are postponed, but the London Shoulder Specialists are still available for consultation.

Consultations can be carried out either by telephone or video link.

Appointments can be arranged by emailing appointments@fortiusclinic.com or by calling 020 3195 2442.

shoulder surgery consultation

What to expect at your shoulder surgery consultation

The unique and complex anatomy of the shoulder joint means it has the greatest range of motion, but also makes it most susceptible to repetitive injuries, ageing and stress. Most problems in the shoulder involve the muscles, ligaments and tendons rather than the bone.

Shoulder pain can be the result of a number of conditions, including trauma to the shoulder, rotator cuff damage, tears to the glenoid labrum, acromioclavicular (AC) joint injury, frozen shoulder or instability and dislocation.

Many shoulder injuries can be addressed at home through RICE method – Rest, Ice, Compression and Elevation – but you should arrange a consultation with a shoulder specialist if you’re experiencing the following symptoms:

  • Your shoulder joint looks swollen and deformed
  • Intense pain around the shoulder
  • Inability to move the shoulder or perform normal activities
  • Audible popping or cracking sound
  • Shooting pain down the arm
  • Numbness or weakness in the arm or hand

During your shoulder surgery consultation, your London Shoulder Specialist will take a full medical history. In particular, assessing the degree of pain, loss of function and sleep disturbance you’re experiencing. Details of your symptoms and your lifestyle – sporting activities you enjoy regularly or type of employment – will guide the diagnosis.

They will also discuss any other treatments you’ve undergone and perform a physical examination to assess the range of motion and strength in the shoulder.

If required, your London Shoulder Specialist will order imaging tests. X-rays do not show the soft tissues but can be used to identify changes in the shoulder blade shape, bone spurs or fractures. An X-ray can assess wear or tear of the ball and socket or collar bone which would indicate osteoarthritis. An ultrasound can reveal tears in the tendons or impingement. At that point, you may require an MRI which will deliver a much clearer image of the soft tissues.

Questions to ask your shoulder surgeon during your consultation

Important areas to cover include whether surgery is the right choice for you at this time and what you can expect if you don’t choose to go ahead with surgery. You can also ask about the surgeon’s own experience, including success rates and possible complications.

  1. Is surgery my best option?
  2. Are my expectations from surgery realistic?
  3. What are the alternatives treatment options?
  4. If I delay surgery at this time, what are the implications in terms of function and pain?
  5. What is the recovery like after shoulder surgery?
  6. What complications can I expect after this surgery and how will these be managed?
  7. How many of these procedures have you performed and what are your success rates?
  8. Where will the operation be carried out?

To arrange a shoulder surgery consultation with the London Shoulder Specialists, call us on 020 3195 2442 or email appointments@fortiusclinic.com. Although all non-urgent / elective surgery bookings and appointments are postponed at the moment, we are still available for consultation either by telephone or video link.

Preparing for shoulder surgery

Preparing for shoulder surgery

As our nation’s healthcare resources are directed to handle the Coronavirus crisis, the result has meant a complete suspension of all private, elective surgery following the agreement formed last month between the NHS and the independent sector to reallocate the latter’s hospital capacity to NHS use.

The NHS has also understandably now cancelled all routine operations for the next three months, leaving many patients in limbo waiting to undergo much-needed surgery. However, even though there is now some uncertainty over when your shoulder operation may take place, it’s never too early to start ‘PreHabing’ before your operation.

PreHab encompasses all the same aspects of your post-surgery rehabilitation programme, touching on elements of nutrition, exercise and pain management, but you should embark on PreHab in advance of your surgery to ensure optimal recovery and the ultimate success of your procedure.

Ideally, you should have at least a few months pre-procedure to get in the best possible health. Some lifestyle factors that increase your surgical risk, such as smoking or being overweight, should be addressed as early as possible for you to experience the benefits.

1. Lose weight

The impact of carrying extra weight on your hip and knee joint is self-evident, but it can also cause shoulder pain, with normal range of motion diminished by nearly 40%, causing increased wear and tear.

A recent study also found that the higher the patient’s BMI, the more chance of post-surgical complications, including the need for revision surgery.

2. Quit smoking

 Stopping smoking in advance of rotator cuff tear or labral repair is probably one of the most important things you can do to improve your chances of surgical success – in fact, some believe that smoking may be the most important factor in your risk of developing complications after shoulder surgery, which can include infection, poor wound healing or less than satisfactory results.

This is supported by a number of studies, including a 2018 report into smoking and arthroscopic rotator cuff repair, published in the British Medical Journal Open Sport & Exercise Medicine, that found that although smokers will still benefit from surgery, they tend to present with larger tears and had a worse initial outcome and a lower functional improvement after surgery.

3. Address health concerns

 Not all shoulder surgery patients present with a secondary health condition, but diabetes can increase your risk of tendon damage, particularly rotator cuff tears. Tendon damage in type 1 and type 2 diabetes is the result of an accelerated production of advanced glycation end products (AGEs) that affect the structure of tendons and how they perform. Raised blood sugar levels can also affect your healing post-procedure, so addressing your diet during your PreHab can help you keep your blood sugar levels down.

 4. Start moving

 Although PreHab encompasses diet and other lifestyle factors, exercise is probably one of the most important aspects. Before any joint procedure, including shoulder surgery, improving the strength, flexibility and range of motion in the muscles that support the joint is essential. A quicker healing process post-procedure can be the direct result of the work you put in beforehand.

For more advice on how best to prepare for shoulder surgery, call us on 020 3195 2442 or email appointments@fortiusclinic.com. Although all non-urgent / elective surgery bookings and appointments are postponed at the moment, the London Shoulder Specialists are still available for consultation either by telephone or video link.

shoulder arthritis in younger patients

Don’t Shrug Off Shoulder Pain: Treating Shoulder Arthritis in Younger Patients

Shoulder arthritis is most commonly associated with old age. However, did you know it can also present in younger patients too? UK star Paddy McGuinness has revealed his struggle with arthritis since he was diagnosed aged 45. He has recently undergone surgery to correct his right shoulder after suffering from arthritis symptoms for years.

While it’s common for patients, particularly younger ones, to hold off seeking treatment for shoulder pain, it is crucial early treatment is sought. Here, we’ll look at shoulder arthritis in younger patients and the treatment options available.

Understanding shoulder arthritis in younger patients

Treating older patients with shoulder arthritis has typically been a lot easier for surgeons than treating younger patients with the condition. This is because they know a shoulder arthroplasty will work well in older patients. However, for younger patients, they aren’t typically known to be good candidates for the procedure. That is, until additional research was carried out into arthroplasty for younger patients.

Could joint replacement surgery be key?

A new study has shown that joint replacement surgery can help to relieve pain and improve mobility in the shoulder in patients 50 and younger. The study followed 23 patients, all younger than 50, who underwent arthroplasties between 1986 and 2005. They also looked at 10 patients who simply underwent a humeral head replacement. All reported chronic shoulder pain caused by arthritis.

The results of the study showed that after joint replacement surgery, the patients had significantly lower pain, alongside improved motion. Both partial and full replacement of the joint showed great success in younger patients. This shows surgeons the benefits of the surgery in patients who would previously have been considered as unsuitable for the procedure.

A full joint replacement or humeral head replacement?

While the full joint replacement has shown great results in reduced pain and improved motion, in younger patients there are some concerns over its longevity. The implants used don’t always withstand a lot of wear and tear. This means, younger patients who want to return to an active lifestyle may find it causes issues with full joint replacement. They are known to loosen over time and cause reduced function in younger patients.

The alternative is to undergo humeral head replacement. This too showed great results in the small study. It would result in a better range of motion and reduced pain, without risking the glenoid from loosening with activity.

What other treatment options are available?

Surgery is the only real treatment option available for shoulder arthritis in younger patients. It is known to worsen over time, meaning treatment should be sought quickly.

That being said, if the arthritis isn’t too severe, it could be treated with physical therapy initially. Some exercises can improve the range of motion. Relief may also be felt through certain anti-inflammatory medications.

Overall, this new research proves promising in the treatment of shoulder arthritis in younger patients. As it is a chronic condition, treatment should be sought as early as possible to prevent it from worsening and causing more significant pain and loss of motion.

If you’re concerned you are suffering from shoulder arthritis, call  0203 195 2442 to arrange a consultation at the London Shoulder Specialists.

shoulder impingement

Is My Shoulder Pain a Sign of Shoulder Impingement?

Sometimes referred to as swimmers’ shoulder, shoulder impingement is a common and painful condition. The trouble is, it can easily be overlooked, particularly in athletes and those who like to hit the gym frequently. Shoulder pain is often considered a normal part of exercise and training. So, how do you know whether or not you’re actually suffering from shoulder impingement?

Here, you’ll discover more about shoulder impingement and the symptoms it presents. We will also reveal the treatment options available and whether it can be prevented.

What is shoulder impingement?

Shoulder impingement is typically caused by the bursa or tendons rubbing against the blade of the shoulder. It tends to occur due to overuse and worsens over time if left untreated. As the bursa or tendons continuously rub against the shoulder blade, it caused inflammation and pain. It also leads the bursa or tendons to become trapped or compressed when the arm is lifted overhead.

Understanding the symptoms of shoulder impingement

Like all shoulder injuries, the main symptom you’ll feel with shoulder impingement is pain. Specifically, you’ll find it difficult to raise your arm past your shoulder. You’ll also experience pain when reaching your arm behind your back.

Alongside pain, other shoulder impingement symptoms include:

  • Stiffness and throbbing
  • Aching
  • Loss of strength
  • Difficulty using the shoulder

It isn’t uncommon to experience stiffness and throbbing. Patients have often referred to the pain experienced as more of a toothache type pain. Even when resting the arm, you may also find it aches a lot, and there may be a loss of strength in the shoulder.

As the condition worsens over time, you’ll start to have difficulty using the shoulder and the strength in the arm will decrease further.

Is shoulder impingement preventable?

While it isn’t always possible to prevent shoulder impingement, there are some measures you can take to reduce your chances of developing it.

Building up the strength in your shoulders is a good idea, particularly if you’ll be using them frequently in a competitive sport environment. You’ll also want to make sure you warm up correctly before exercising.

Ensuring you’re using the correct techniques for the sport you’re competing in will also help. Then finally, giving the shoulders adequate rest between exercise is crucial.

How is shoulder impingement treated?

If you suspect you are suffering from shoulder impingement, it’s important to seek a diagnosis as quickly as possible. The earlier it is spotted, the easier it will be to treat. To start, anti-inflammatory medication and physical therapy may be recommended for mild cases.

Ultrasound-guided injections may also be used and combined with physiotherapy before surgery is considered. If non-invasive treatments don’t work, surgery may be recommended. Here, the surgeon will widen the area around the rotator cuff to prevent any friction. If a rotator cuff tear is identified, surgery may also be required to repair that too.

There are many different potential causes of shoulder pain, but if you experience pain using overhead movements, it could point to shoulder impingement. Book a consultation today to get to the cause of your shoulder pain and identify the best treatment method to resolve it.

swimmers shoulder

Swimmers Shoulder Common in More than 75% of Swimmers

New research has revealed that over 75% of swimmers suffer from swimmers’ shoulder. It is believed that heavy training is the leading cause of injury, followed closely by a ‘no pain no gain’ philosophy.

Here, we’ll look at the most recent research and its findings, alongside what swimmers’ shoulder is and how it can be prevented.

What is swimmers shoulder?

Swimmers shoulder is a term given to numerous shoulder injuries sustained during swimming. They are typically experienced due to overuse of the joint and cause varying level of pain.

When you swim, the shoulder joint is placed under a lot of strain. It is put through a lot of different motions, each of which can cause a different type of overuse injury. While the shoulder is one of the most mobile joints in the body, it isn’t the most stable. This means injuries due to overuse are common.

What did the research reveal?

The recent research into swimmers’ shoulder published within the American Academy of Paediatrics, revealed that the distance swam by competitive swimmers played a key role in shoulder injury.

The team assessed youth club and high school swimmers at a competitive level. They discovered many of the children were suffering with shoulder pain, linked to how far they swam each day. They also discovered that the children believed pain was a natural part of swimming competitively.

It was also revealed that swimmers’ clubs had more children who suffered from shoulder pain compared to high school teams. This seems to link to the fact that swimming clubs cover more distance and more frequent training sessions.

A total of 150 children were assessed in the study. It discovered that 76.7% had experienced shoulder pain over the past year. A staggering 66% of them also revealed that they felt they should tolerate milder shoulder pain if they want to succeed. Half of those questioned also said they knew a competitor who relied upon pain medication.

Those who reported pain tended to swim 2,001 to 6,322 yards per training session. Those who experienced no pain swam a total of 1,568 to 3,513 yards per session.

Is swimmers shoulder preventable?

The research shows two things that could help prevent swimmers’ shoulder. The first is the attitude towards shoulder pain. Young athletes need to understand the seriousness of shoulder pain and the conditions it can link to. Once pain is experienced, adequate rest of the shoulder should be provided.

Another way that swimmers can reduce their risk is to avoid overtraining. Carrying out strengthening exercises will ensure the muscles of the shoulder are better equipped to handle the strain they are placed under. Keeping an eye on the distance they cover in each session will also help.

However, it isn’t always possible to prevent swimmers’ shoulder. If an injury does occur, it is important to seek treatment as soon as possible. This will prevent extensive time away from the pool and also stop the injury from worsening.

Gender and rotator cuff repair

Gender Differences Revealed in Rotator Cuff Repair Recovery

There are numerous treatments available to treat issues with the shoulder. One of the most common procedures carried out on patients is rotator cuff repair. Now, research has revealed that gender can play a role in the outcome of the surgery.

Here, we’ll look at what the new research has revealed and other factors that can impact the success rate of the procedure.

What is rotator cuff repair?

Rotator cuff repair is a surgical procedure which aims to repair torn tendons within the shoulder. There are two main methods that can be used, including open incisions and shoulder arthroscopy. The latter tends to be the preferred method, particularly for mild to moderate tears.

The procedure is typically carried out under general anaesthetic and the method will depend upon the severity of the injury. In a typical procedure, the tendons are re-attached to the bone using small anchors, which have sutures running through them. These then repair the tendon to the bone.

It can be a fairly intensive surgical procedure with a long recovery time; post-surgery recovery depends mainly on the severity of the tear being mended, but another potential factor – gender – has now been identified.

How does gender impact the procedure?

A new cohort study was carried out to compare the outcomes of the procedure in men and women. It included 283 patients in total, 130 of which were female and 153 were male.

All patients underwent a primary arthroscopic rotator cuff repair. A total of 275 patients completed a one-year follow-up. It was discovered that women generally reported higher levels of pain after two weeks, six weeks and three months. This also meant that the use of pain medications to control the pain was higher in women.

Additionally, women also reported more restricted movement in the shoulder after the procedure. Interestingly, there were no sex-related differences reported after one year. So, the study shows that women tend to suffer more from the procedure in the first few months after a rotator cuff repair.

What other factors can impact the results?

As well as gender, there are other factors which can impact the results of a rotator cuff repair. These include:

  • Age
  • Size and severity of the tear
  • Smoking
  • Diabetes

Older patients tend to experience more negative results, as do smokers. There have been many studies conducted which have shown smoking can greatly reduce healing and promote infection.

Obviously, the size and severity of the tear will also determine how successful rotator cuff repair surgery is. Larger, more severe tears are trickier to fix and can require more extensive surgery.

These are just some of the main risk factors patients need to be aware of. Before undergoing a rotator cuff repair, it’s important for patients to discuss the procedure and be aware of the risks involved. This latest study enables shoulder specialists to provide more accurate information over the risks of the surgery for women. It also gives patients more of an idea of what to expect from the procedure. If you have further questions for the London Shoulder Specialists, call 0203 195 2442.