Rotator cuff repair
Rotator cuff repair is surgery to repair a torn tendon in the shoulder. The procedure can be done with a large (open) incision or with shoulder arthroscopy, which uses smaller incisions.
Surgery - rotator cuff; Surgery - shoulder - rotator cuff; Rotator cuff repair - open; Rotator cuff repair - mini-open; Rotator cuff repair - laparoscopic
The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its joint and help the shoulder joint to move. The tendons can be torn from overuse or injury.
You will likely receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you will have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.
Three common techniques are used to repair a rotator cuff tear:
To repair the rotator cuff:
At the end of the surgery, the incisions are closed, and a dressing is applied. If arthroscopy was performed, most surgeons take pictures of the procedure from the video monitor to show you what they found and the repairs that were made.
Why the Procedure Is Performed
Reasons rotator cuff repair may be done include:
Surgery is a good choice when:
A partial tear may not require surgery. Instead, rest and exercise are used to heal the shoulder. This approach is often best for people who do not place a lot of demand on their shoulder. Pain can be expected to improve. However, the tear may become larger over time.
Risks for anesthesia and surgery in general are:
Risks for rotator cuff surgery are:
Before the Procedure
Tell your health care provider what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
On the day of surgery:
After the Procedure
Follow any discharge and self-care instructions you are given.
You will be wearing a sling when you leave the hospital. Some people also wear a shoulder immobilizer. This keeps your shoulder from moving. How long you wear the sling or immobilizer will depend on the type of surgery you had.
Recovery can take 4 to 6 months, depending on the size of the tear and other factors. You may have to wear a sling for 4 to 6 weeks after surgery. Pain is usually managed with medicines.
Physical therapy can help you regain the motion and strength of your shoulder. The length of therapy will depend on the repair that was done. Follow instructions for any shoulder exercises you are told to do.
Surgery to repair a torn rotator cuff is often successful in relieving pain in the shoulder. The procedure may not always return strength to the shoulder. Rotator cuff repair can require a long recovery period, especially if the tear was large.
When you can return to work or play sports depends on the surgery that was done. Expect several months to resume your regular activities.
Some rotator cuff tears may not fully heal. Stiffness, weakness, and chronic pain may still be present.
Poorer results are more likely when the following are present:
Hsu JE, Gee AO, Lippitt SB, Matsen FA. The rotator cuff. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, eds. Rockwood and Matsen's The Shoulder. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 14.
Phillips BB. Arthroscopy of the upper extremity. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 52.
Rudolph GH, Moen T, Garofalo R, Krishnan SG. Rotator cuff and impingement lesions. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 52.
Review Date: 4/18/2017
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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