Shoulder tendon and ligament repair

Tendons and ligaments in the shoulder are soft tissues that support the fluid movement and stability of the shoulder joint. When tendons or ligaments are injured or overused, they may need repair to restore their full range of motion, improve strength, and reduce pain. Milder tendon and ligament issues often respond well to conservative treatment, like rest, icing, and physical therapy. More severe damage, including partial or complete tears, can require surgery, which is often performed using minimally invasive arthroscopic techniques. Shoulder tendon repair surgery is commonly used to treat damaged rotator cuffs and biceps tendons.

Shoulder pain and loss of function can impact every aspect of your life from driving, lifting, and housework to self-care and sleeping. At Penn Medicine, our goal is to alleviate and eliminate your shoulder pain and restore your shoulder movement to its maximum function. Our orthopaedic team specializes in individualized care for shoulder treatment and considers your health history, lifestyle, and preferences to create a treatment plan that’s right for you.

Various surgical techniques are used when repairing shoulder tendon or ligament tears. Several procedures may be performed at the same time and may include:

• Debridement: Fragments of tendons or ligaments may be removed from the affected area to prepare it for repair. This may also include smoothing of bones.
• Reattachment: Soft tissue may be sewn together or affixed to bones.
• Tissue transfer: Ligaments or tendons may be transferred from a healthy part of your body (or from a donor) to replace damaged tissues.

Your doctor will discuss which techniques will be used to repair your shoulder tissues and answer any questions you have.

Your surgeon will provide you with instructions on how to prepare for surgery. They may order pre-surgical tests, such as blood tests, MRIs, and x-rays, to be sure you are ready for your procedure.

On the day of the surgery, you can expect these steps:

• You’ll receive regional anesthesia and sedation to numb your body or general anesthesia to put you to sleep.
• In most cases, you’ll have a minimally invasive procedure in which your surgeon will make a small incision in your shoulder. Optionally, conventional open surgery may be performed with a larger incision.
• Your surgeon will inspect the affected area and cut out or trim any damaged tissues.
• Your surgeon will make the repairs, which may include sewing soft tissues together, reattaching tendons or ligaments to the shoulder bones, or transferring tissues to replace damaged ones.
• Incisions will be closed, and you’ll be moved to a recovery area for observation as the anesthesia wears off.
• You’ll be given home-care instructions to care for the wound and learn about next steps for follow-up care.

Most people go home the same day.

Whether you have surgery to repair a shoulder tendon or ligament, the recovery process is largely the same.

• After your surgery, you’ll need plenty of rest to begin the healing process.
• Your doctor will create a pain management program to relieve any discomfort.
• Your shoulder and arm will be immobilized in a sling or wrap to keep it in the optimal position to support repair.
• You’ll start a physical rehabilitation program to regain strength, range of motion, and function.
• Over time, you’ll return to your regular daily activities and then progress to more vigorous use of the shoulder.

Recovery may take weeks or months, depending on the extent of the surgery, your rehabilitation progress, and your overall health. Your doctor and physical therapy team will continue to monitor your progress and provide support to meet your recovery milestones.

All surgeries carry some risks, including bleeding, infection, and adverse reactions to anesthesia. While shoulder surgery is considered a safe procedure and has few complications, there are potential risks when repairing shoulder tendon and ligament tears, including:

• Shoulder stiffness or weakness
• Persistent pain
• Limited range of motion
• Nerve or blood vessel damage

Be sure to discuss any risks with your doctor before moving forward with shoulder surgery.

Penn Medicine’s orthopaedic surgeons and rehabilitation specialists have deep knowledge and expertise in treating shoulder tendons and ligaments, from mild injuries to the most complex tears. We offer the latest diagnostic techniques, including advanced imaging that allows for greater visualization to pinpoint the cause of your shoulder pain. We treat the ‘whole patient’ and listen to your concerns and preferences through detailed evaluations, individualized treatments, and ongoing support.

At Penn Medicine, you can expect:

• Wide-ranging expertise: We’re highly experienced in common and complex surgery techniques for the shoulder, including tendon and ligament repair, advanced arthroscopic methods, and total shoulder replacement.
• Advanced treatments: We work closely with Penn Medicine researchers to offer the latest treatments and surgical techniques as soon as they become available, offering care that may not be widely available elsewhere.
• Second opinions: Our orthopaedic specialists see a large number of people who seek second opinions to confirm a diagnosis and treatment plan. This helps avoid a misdiagnosis or inadequate treatment plan.
• Convenient locations: We provide accessible care in the southeastern Pennsylvania and New Jersey regions, so you don’t have to travel far to receive world-class care.