Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
A rotator cuff repair is a procedure in which torn tendons and/or muscles of the shoulder are surgically fixed. Rotator cuff tears can cause pain and weakness.Sometimes these tears can heal without surgery, but severe rotator cuff damage can be permanent without surgical intervention.
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What Is Rotator Cuff Repair?
A rotator cuff repair is a surgical operation used to mend damaged or injured structures of the rotator cuff.The rotator cuffincludes the tendons and muscles of theshoulder joint, also called the glenohumeral joint. Sometimes rotator cuff repair also involves other steps, such as removal ofbone spurs.
Rotator cuff repair is usually an outpatient procedure that doesn’t involve an overnight stay in the hospital.
The surgery can be done as anopen procedureor aminimally invasive arthroscopicone. The right surgical approach for you depends on the extent and exact location of your rotator cuff damage and the optimal means of accessibility for your repair.
Rotator cuff repair techniques include:
Contraindications
Chronic illnesses, like cancer, may interfere with post-operative healing. If you have an infection or if you are immunocompromised, you could be at risk of a post-operative infection, which might be a reason to delay your surgery.
While they are not strict contraindications, smoking and diabetes are associated with impaired healing and may impact support for surgery as well.
These issues aside, rotator cuff repair is simply not right for every such injury. Sometimes the tendon or muscles are so badly damaged thatrepair might not be possible.For example, largerotator cuff tearsor multiple rotator cuff tears may be associated with degeneration or fractures of the neighboring cartilage or bone.
These situations generally require shoulder replacement surgery and not just a rotator cuff repair. You might have acomplete shoulder replacement, apartial shoulder replacement, or areverse shoulder replacement.
Potential Risks
Rotator cuff surgery is usually safe and effective. Still, there are someinherent risks of any kind of surgeryandanesthesiathat apply. Additionally, rotator cuff repair surgery can cause specific post-surgical issues such as:
You would likely develop symptoms of pain, weakness, or swelling within a few weeks after surgery if you experience surgical complications.
Purpose of Rotator Cuff Repair
This type of damage may occur due to repetitive motion or sudden injury. Even with repetitive damage, a rotator cuff tear can slowly worsen or may occur abruptly.
Symptoms of rotator cuff tear include:
Your healthcare provider will do a physical examination to evaluate these symptoms. Your evaluation will include an assessment of your strength, sensation, and areas of tenderness. You may also have diagnostic tests, such as an X-ray or magnetic resonance imaging (MRI) test.
Your tendons and/or muscles can be partially frayed, frail, or completely ripped. You might also have degeneration of cartilage, bone fractures, or bone spurs.
Treatment often starts withconservative therapyand may include rest, physical therapy, and oral or injected anti-inflammatory medication.
Small tears in your rotator cuff can heal. If your symptoms don’t improve with non-surgical management or if your injury is so severe that it isn’t likely to heal without an operation, your healthcare provider will discuss the surgical options with you.
Rotator Cuff Injuries
Prior to your surgery, your surgeon will obtain imaging tests to plan your procedure. This can include different views of your joint. You will also have preoperative tests to prepare for anesthesia, including anelectrocardiogram (EKG), chest X-ray,complete blood count (CBC), andblood chemistry panel.
You and your healthcare provider will discuss the recovery process, the type of surgery that is best for you, and the location and size of your incision.
Location
Your surgery will be done in an operating room that can be located in a hospital or a surgical center. A rotator cuff repair is an outpatient procedure, so you will come to your appointment from home and go home on the same day.
What to Wear
You can wear anything comfortable to your surgery appointment. You will need to change into a hospital gown for your procedure.
Since you will have your shoulder wrapped and in a sling after surgery, you should bring loose clothes that you can slip over your surgical dressing to wear on your way home.
Food and Drink
You should abstain from eating and drinking after midnight the night before your scheduled surgery.
Medications
Your healthcare provider might ask you to stop or adjust some of your regular prescriptions for several days prior to your surgery if you takeblood thinnersor anti-inflammatory medications.
What to Bring
When you go to your surgery appointment, you need to bring your identification, insurance information, and a form of payment if you are expected to pay for a portion of the cost of your surgery.
You won’t be able to drive yourself home, so you will need to have someone with you who can drive you home.
Pre-Op Lifestyle Changes
What to Expect on the Day of Surgery
When you go to your surgical appointment, you will need to sign in and fill out a consent form. You might have same-day pre-operative tests, including a CBC, blood chemistry,urine test, and a chest X-ray—even if you’ve had these tests before.
Your healthcare provider may examine your shoulder and your movement on the day of surgery to determine whether you have had any changes since your most recent physical examination.
Before the Surgery
You will go to a pre-surgical area, where you will change out of your clothes. You will have your temperature, pulse, blood pressure, respiratory rate, and oxygen level checked.
You will then be taken to the operating room to have your surgery, where a nurse will place an intravenous (IV, in a vein) line in your hand or arm for the administration of your anesthesia medication.
Your surgical team will place a drape over you, exposing the area where your healthcare provider will place your incision. Your skin will be cleansed to reduce the chances of an infection.
Pain will be controlled withgeneral anesthesia,regional nerve block anesthesia, or, more than likely, both.
General anesthesia medication is injected into your IV to make you fall asleep and prevent you from moving or having sensation. If you have general anesthesia, your anesthesiologist will place a tube in your throat so you will have mechanical assistance with your breathing.
Regional anesthesia for rotator cuff repair is generally placed for an interscalene brachial plexus block. You may have the anesthetic medication injected with a needle that is immediately removed, or your anesthesiologist may leave a catheter in place during your surgery for continued injection of pain medication.
During the Surgery
Your surgery will begin after your anesthesia is started and verified to be working.
Your surgeon will make an incision on your shoulder, the size of which is dependent on the technique being used. A small arthroscope will be placed if you are having an arthroscopic procedure.
You may need to have removal of bone spurs or damaged tissue. Your healthcare provider may need to cut connective tissue or muscle in order to reach a torn ligament or muscle of your rotator cuff. Typically, thedeltoid muscleis cut during an open or mini-open rotator cuff repair, but muscle does not need to be cut for an arthroscopic rotator cuff repair.
The damaged area will be repaired with sutures or a torn ligament may be attached to the corresponding bone with metal surgical anchors or anchors that will dissolve over time.
If you are having a tendon transfer, a tendon will be taken from another area of your body, typically from thelatissimus dorsiin your back, and surgically positioned in place of your torn rotator cuff tendon.
After repair of your torn structures, your surgeon will mend any tissue that was cut for surgical access. Your skin will be closed with sutures, and bandages will be placed on the surgical wound.
When your surgery is complete, your anesthesia will be stopped or reversed, and your breathing tube will be removed. Your anesthesia team will ensure that you are stable and breathing comfortably on your own before you are taken to a postoperative recovery area.
You may have your arm placed in a sling in the operating room or when you get to the postoperative recovery area.
After the Surgery
As you are waking up after surgery, your medical team will continue to monitor your breathing, pulse, blood pressure, and oxygen. You will receive pain treatment as needed.
You will be given instructions regarding wound care, activity, pain control, and when and how to restart any medications that you were asked to adjust prior to your surgery.
Your healthcare provider will likely examine you to ensure that things are going as planned. If you are not having any complications, you should be discharged to go home a few hours after your surgery.
It will take four to six weeks for your wound to heal after rotator cuff surgery, and four to six months for full recovery.You will need to use your arm sling for several weeks; your healthcare provider will let you know when to stop.
Generally, the more extensive and open your surgery, the longer it will take you to heal and recover. Shorter recovery time is associated with arthroscopic rotator cuff repair.
Throughout your healing and recovery period, you will see your healthcare provider for follow-up appointments. They will examine your shoulder, assess your range of motion, and remove your sutures.
1:36Click Play to Learn About the Shoulder Surgery Rehab Timeline
1:36
Click Play to Learn About the Shoulder Surgery Rehab Timeline
Healing
As you are healing, you may need to take pain medication. Be sure to call your healthcare provider if you are experiencing severe or worsening pain.
Warning signs of complications include:
Call your healthcare provider’s office if you experience any of these issues.
Throughout the healing process, you need to be sure to keep your dressing and your wound clean and dry. Care for it according to the instructions that you were given upon discharge.
How to Care For Your Incision After Surgery
Activity
You might be instructed to limit movements of your surgical shoulder for the first week if you’ve had an arthroscopic procedure, and possibly for several weeks after an open procedure. This can affect your ability to do things like drive, self-care, and work.
You will be instructed to increase your level of activity gradually so you can optimize your shoulder strength and motion. Be sure to follow your medical team’s guidance as to what activities you can do, when—and what signs should prompt you to stop.
Supervised rehabilitationand physical therapywill be necessary. At your sessions, you will participate in active and passive movements to strengthen your shoulder and to prevent it from getting stiff.
Rehabilitation After Rotator Cuff Surgery
Lifestyle Adjustments
After you have fully healed, you should be able to move your arm with an improved range of motion and without pain. It is important that you stay active to avoid stiffness of your arm.
That said, you must discontinue any activity or repetitive movements that could cause another injury. While it is important to keep moving, you need to make sure that you avoid future damage.
Talk to your healthcare provider and physical therapist about modifications you may need to take at work or in sports to prevent further injuries.
Possible Future Surgeries
Typically, a rotator cuff repair surgery is a one-time procedure without a plan for follow-up procedures or additional surgical steps.
A recurrent tear can develop years after a repair. Generally, more extensive presurgical damage is more likely to result in a repeat injury after a rotator cuff repair than less severe presurgical damage.
A Word From Verywell
A rotator cuff repair surgery can improve your quality of life if you have pain or limited range of motion due to a rotator cuff tear. There are several surgical methods used for this type of repair, and the right one for you depends on the extent and location of your injury.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tseng YH, Chou WY, Wu KT, et al.Use sonoelastography to predict the reparability of large-to-massive rotator cuff tears.Medicine (Baltimore). 99(27):e21139. doi:10.1097/MD.0000000000021139
American Academy of Orthopedic Surgeons.Rotator cuff tears: Surgical treatment options.
Kany J, Sekaran P, Amavarathi RS, et al.Posterior Latissimus Dorsi Transfer For Massive Irreparable Posterior-superior Rotator Cuff Tears: Does it Work In The Elderly Population? A Comparative Study Between Two Age Groups (≤55 Versus ≥75 Years old) [published online ahead of print, 2020 Jul 7].J Shoulder Elbow Surg. S1058-2746(20)30534-6. doi:10.1016/j.jse.2020.06.018
Jensen AR, Taylor AJ, Sanchez-Sotelo J.Factors Influencing the Reparability and Healing Rates of Rotator Cuff Tears [published online ahead of print, 2020 Jul 17].Curr Rev Musculoskelet Med. 10.1007/s12178-020-09660-w. doi:10.1007/s12178-020-09660-w
Sabzevari S, Kachooei AR, Giugale J, Lin A.One-stage surgical treatment for concomitant rotator cuff tears with shoulder stiffness has comparable results with isolated rotator cuff tears: a systematic review.J Shoulder Elbow Surg. 26(8):e252-e258. doi:10.1016/j.jse.2017.03.005
American Society of Regional Anesthesia and Pain Medicine.Outpatient orthopedic shoulder surgery: Your pain relief options.
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