Rotator Cuff Repair Info Consent

Q: Who performs rotator cuff surgery in Rockhampton?

Dr Kieran Hirpara is a fellowship-trained shoulder and rotator cuff surgeon based at Mater Private Hospital Rockhampton, with subspecialty fellowship training in shoulder and elbow surgery (Brisbane). He manages the full rotator cuff pathway — diagnosis, arthroscopic repair, and graduated rehabilitation — for patients across Central Queensland. A GP referral lets the practice arrange assessment and, where surgery is indicated, schedule the repair.

Q: What's the difference between conservative management and surgery for a rotator cuff tear?

Many small to medium chronic cuff tears settle with a structured physiotherapy programme — the rotator cuff includes four tendons and the unaffected ones can compensate for a damaged one in many patients. Surgery is offered when the tear is acute, when the tear is large or progressing, when weakness is dominating function, or when a patient has tried physiotherapy and isn't getting where they want to be. The decision is individual; the consultation walks through both pathways.

Q: What's the chance of the cuff re-tearing after surgery?

The published re-tear rate varies with tear size, tendon quality, patient age and post-operative compliance — small repairs in younger patients with good tendon tissue have the lowest rates, and large or massive tears in older patients carry higher risk. Functional outcomes often remain good even when imaging shows a partial re-tear, because patients can regain comfort and motion regardless of the imaging picture. Individual risk is discussed at consult.

Q: How much does rotator cuff repair cost? What does Medicare cover?

Rotator cuff repair involves separate fees for the surgeon, anaesthetist, assistant, hospital and surgical implants (anchors and sutures). The practice quotes the surgical fee in writing before the operation is booked — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

Q: Why does the sling stay on for six weeks?

The repaired tendon is held to bone by anchors and sutures, but the biological healing — tendon reattaching to bone — takes around six weeks for the soft attachment and many months for the full mature attachment. Active use of the shoulder during the first six weeks puts load through the repair before the biology has caught up, and is the most common cause of early failure. The sling protects the repair until the tendon-bone interface is strong enough to tolerate load.

Q: When can I drive again after rotator cuff repair?

Driving requires both arms free of a sling and the ability to control the wheel and indicators safely. For most patients that is around six weeks for an automatic vehicle and a little longer for a manual. The practice does not certify fitness to drive for insurance purposes — driving fitness is a decision between the patient, the GP and the insurer — but the post-operative review at six weeks is the natural point at which the question is discussed.

Q: Will physiotherapy be enough on its own?

For many patients, yes — particularly small to medium chronic tears in older patients with low overhead demands. A structured programme of scapular control, gradual cuff loading and posterior-chain strengthening can reliably settle pain and restore function. For acute tears in younger patients, large tears with weakness, and tears that have failed a course of physiotherapy, surgical repair gives a more reliable outcome. The first consult is often as much about deciding the pathway as it is about scheduling surgery.

Q: What activities can I return to after rotator cuff repair?

The aim is a pain-free shoulder with enough range and strength for work, sport and daily life. Most patients return to non-physical work by six weeks, recreational gym at four to six months, and full sport including overhead and contact activities by nine to twelve months. Manual occupational labour is staged carefully — heavy overhead work in the first six months risks the repair. Long-term outcomes correlate with the pre-operative tear pattern and the post-operative rehab compliance more than they do with the surgical technique itself.

Medical illustration of a supraspinatus rotator cuff tear. — A torn supraspinatus tendon — the most common rotator cuff tear pattern. The repair operation re-attaches the torn tendon back onto the upper arm bone using small anchors. Nucleus Medical Media 4.0

Rotator cuff repair reattaches torn tendons to bone, improving pain and function when conservative treatment fails.

Why this operation has been suggested

This operation repairs a torn shoulder tendon using a small camera and keyhole incisions. Your surgeon likely recommended it because non-surgical treatments like physical therapy did not give you enough relief from pain or weakness. While many people can manage with therapy alone, surgery is often suggested when the tear is large, the tendon has failed to heal, or your symptoms are severe and limit your daily life.

The main goal is to restore your shoulder function and reduce pain. Evidence shows that most patients achieve significant improvement in how they use their arm within 12 months. Even for older patients or those with large tears, this repair can provide lasting relief and better movement compared to not having surgery.

Before the operation

Your surgeon will likely order X-rays, an MRI, blood tests, and an anaesthetic review to check your shoulder and overall health. Please bring a list of all current medications and wear comfortable clothing to your visit. You must fast before the surgery and stop certain medicines as your surgeon instructs. Arrange for someone to drive you home, as you cannot drive yourself. Your surgeon performs this repair using an arthroscopic (keyhole) approach with two or three small incisions and a small camera inside the joint. This method allows the surgeon to see and treat the tear through tiny openings.

On the day

You will arrive at the hospital and meet your anaesthetist before the operation. They will explain how your pain will be managed and answer any questions you have. This operation is done under general anaesthetic combined with a regional nerve block. You will be fully asleep for the operation, and the block — an injection that numbs the nerves supplying the arm before you wake up — provides pain relief for the first 12 to 24 hours after surgery. The anaesthetist will meet you before the operation and talk you through both parts.

Your surgeon will then perform the repair using an arthroscopic approach. This means they use two or three small incisions and a tiny camera inside your joint to see and fix the tear. You will wake up in the recovery area once the procedure is finished. You will be monitored closely until you are ready to go home or to your room.

What the operation involves

Your surgeon will perform this surgery using an arthroscopic, or keyhole, approach. This means they will make two or three small cuts, each about 1 cm long, over your shoulder. Through these tiny openings, they insert a small camera and special instruments to see inside your joint. This method allows them to view the tear from multiple angles without needing a large cut.

First, your surgeon will clean away any scar tissue or inflamed fluid that limits movement. They will then gently release tight tissue to bring the torn tendon back to its normal position. If the tear is large, they may need to remove a small piece of bone at the front of the shoulder to create more space. The surgeon will then reattach your torn tendon to the bone using small anchors and strong sutures. They place these anchors in a trough on the bone surface to ensure a strong hold.

Once the tendon is secured, your surgeon will close the small cuts with dissolving stitches or glue and cover them with a dressing. This procedure is designed to restore the natural shape of your shoulder while minimizing damage to the surrounding muscles.

After the operation

You will wake up in the recovery ward. Your surgeon uses a keyhole approach with two or three small incisions and a small camera inside the joint. You will have a dressing and a sling to support your arm. Pain will be managed with general methods. Most patients go home the same day, but some stay overnight. You must have someone stay with you for the first 24 hours. You can begin gentle movement as advised. Your arm will be protected while it heals.

Recovery

You will likely feel soreness and swelling in your shoulder for the first few days. This is normal. Your surgeon may recommend pain relief to help you rest comfortably. Most people find that pain and swelling begin to settle as you start gentle movement.

You will wear a sling to protect your shoulder while it heals. Your physiotherapist will guide you through specific exercises to keep your arm moving safely. You can perform light daily tasks at home, but avoid lifting anything heavy. Sleep may be difficult at first; propping yourself up with pillows often helps.

As your strength returns, you will gradually do more activities. You can drive once your surgeon clears you to do so. Many patients return to work and sports as their shoulder feels stronger. Your journey is unique, so follow the specific plan your surgeon and physiotherapist create for you.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

Sometimes the tendon does not heal back to the bone. You might notice that your shoulder still feels weak or painful after several months. This can happen even if the surgery looked successful at first. The highest risk for this happens between 6 weeks and 3 months after surgery. If your pain does not improve or returns, tell your surgeon at your next review.

Infection is a possible risk, though rare. You might see redness spreading out from your small cuts, or feel a deep, throbbing pain that does not ease with simple painkillers. You may also notice swelling or warmth. If you see these signs, call the clinic right away.

Blood clots in the leg are a possible risk with routine surgery. You might feel sudden swelling and tenderness in your calf. If this happens, go to the emergency department immediately.

Your shoulder might not feel as good as you hoped, even if the repair holds. Some patients find their function does not improve much after one year. If you feel your shoulder is not getting better, bring it up at your next appointment.

Smoking can affect healing. If you have quit smoking more than 6 months before surgery, your risk is similar to someone who never smoked. If you are still smoking, talk to your surgeon about how this might affect your recovery.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us if you have a fever, increasing redness, or discharge from your small incisions. Go to emergency if you feel sudden severe pain, calf swelling, or shortness of breath. Contact your surgeon immediately if you lose sensation in your arm or cannot move your limb. These signs need urgent assessment to protect your recovery.