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Rotator Cuff Repair

Surgery Overview

Surgery may be used to treat a torn rotator cuff if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.

Surgery to repair a torn rotator cuff tendon usually involves:

  • Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement).
  • Making more room for the rotator cuff tendon so it is not pinched or irritated. If needed, this includes shaving bone or removing bone spurs from the point of the shoulder blade (subacromial smoothing).
  • Sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).

Arthroscopic surgery is the most common way that this surgery is done. But in some cases, the surgeon needs to do open-shoulder surgery, which requires a larger incision.

What To Expect

Discomfort after surgery may decrease with taking pain medicines prescribed by your doctor.

Your arm will be protected in a sling for a defined period of time.

Physical therapy after surgery is crucial to a successful recovery. A rehabilitation program may include the following:

  • As soon as you awake from anesthesia, you may start doing exercises that flex and extend the elbow, wrist, and hand.
  • A physical therapist or a machine may help move the joint through its range of motion.
  • Active exercise (you move your arm yourself) and stretches, with the assistance of a physical therapist, may start 6 to 8 weeks after surgery. This depends on how bad your tear was and how complex the surgical repair was.
  • You'll be taught strengthening exercises a few months after surgery. You'll start with light weights and progress to heavier weights.

Why It Is Done

Surgery to repair a rotator cuff is done when:

  • A rotator cuff tear is caused by a sudden injury. In these cases, it's best to do surgery soon after the injury.
  • A complete rotator cuff tear causes severe shoulder weakness.
  • The rotator cuff has failed to improve with 3 to 6 months of conservative nonsurgical treatment alone (such as physical therapy).
  • You need full shoulder strength and function for your job or activities, or you are young.
  • You are in good enough physical condition to recover from surgery and will commit to completing a program of physical rehabilitation.

How Well It Works

Rotator cuff repair surgery for a tear from a sudden injury works best if it is done within a few weeks of the injury.footnote 1 But repairs of very large tears are not always successful.

Rotator cuff surgery to repair frayed or thinned tendon tissue is less likely to work than surgery to repair an injury to a healthy tendon.

Risks

In addition to the risks of surgery in general, such as blood loss or problems related to anesthesia, complications of rotator cuff surgery may include:

  • Infection of the incision or of the shoulder joint.
  • Pain or stiffness that won't go away.
  • Damage to the deltoid tendon or muscle (if the deltoid is detached, additional surgery may be needed to repair it).
  • The need for repeated surgery because tendons do not heal properly or tear again.
  • Nerve or blood vessel damage (uncommon).
  • Complex regional pain syndrome (rare).

References

Citations

  1. American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Rotator cuff tears. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 311–316. Rosemont, IL: American Academy of Orthopaedic Surgeons.

Credits

Current as of: March 2, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kenneth J. Koval MD - Orthopedic Surgery, Orthopedic Trauma