Rotator Cuff Surgery

Most of these surgeries are performed using an arthroscope, a tiny camera that is inserted through small incisions into the shoulder joint. Shoulder arthroscopy may be performed to diagnose or repair the rotator cuff tear. This minimally invasive approach results in less pain early on than other methods. Traditional open surgery, which requires larger incisions, may be recommended when the tear is large or complex or when shoulder replacement is needed.

Rotator Cuff Tendon Repair
The surgeon re-attaches a completely torn tendon to the top of the upper arm bone. A partial tear may be repaired by trimming or smoothing the rotator cuff. This procedure is called a debridement.

Rotator Cuff Repair Augmentation with Graft
Large rotator cuff tears can be repaired using a piece of tissue called a graft. This additional layer reinforces the repair by thickening and strengthening the tendon.

Tendon Transfer
When rotator cuff tendons are too damaged to be reattached, a nearby tendon can substitute for their function. During this procedure, the transferred tendon is detached from its original position and attached to your upper arm bone (humerus). This allows the new tendon and its muscle to move your arm.

Superior Capsule Reconstruction
This newer procedure restores motion and relieves pain when severe rotator cuff tears can’t be repaired. The shoulder surgeon inserts a tissue graft that attaches from the ball to the socket of the joint. It doesn’t replace the rotator cuff, but substitutes for its function, restoring your shoulder’s motion and stability and reducing pain.

Reverse Shoulder Replacement
When the rotator cuff is torn beyond repair and accompanied by arthritis, reverse shoulder replacement may be the best option. 

Subacromial Balloon Spacer
For people with a rotator cuff repair that keeps recurring and cannot be repaired, an absorbable balloon can be inserted under the the tip of the shoulder blade. This cushions the space between the top of the shoulder blade and the upper arm bone. Early studies show this procedure may be as effective as a partial rotator cuff repair.   

Is Rotator Cuff Surgery an Outpatient Procedure?
Yes, the surgery is typically performed on an outpatient basis, and you can go home the same day.

How Long Does the Procedure Take?
The surgery can take one to two hours, depending on how complex it is.

Is Rotator Cuff Surgery Painful?
You shouldn’t feel any pain during the procedure. Before the surgery, the anesthesia doctor will use ultrasound to inject numbing medication around your nerves to provide a regional nerve block for your shoulder. The medication numbs the area from your neck down through your arm. The doctor may also give you a sedative to help you sleep through the procedure.

How Long Does Pain Last After Surgery?
Depending on the type of regional nerve block (short- or long-acting), the block lasts 18 to 72 hours, so you won’t feel much pain immediately after surgery. Your doctor will recommend you start taking over-the-counter medications, which will keep your pain to a minimum as the nerve block wears off. An ice water cooling sleeve will also diminish pain at night. Following your doctor's instructions for pain management will help minimize the need for narcotic pain medication. Most people do not need prescription pain medication after the first week.

How Long Does It Take to Recover from Rotator Cuff Surgery?
How much time your recovery and rehab take will depend on several factors, including how large your tear is, how long you had it before surgery, and how well you stick with physical therapy appointments and exercises. You’ll likely start physical therapy within a week after surgery. Over the next 16 weeks or so, you’ll gradually progress from assisted movement (your physical therapist or your good arm moving your affected shoulder) to light resistance exercises, to strengthening exercises. Assisted range of motion therapy may be delayed for large tears.

Between six and 12 weeks after surgery you can do light lifting (for example, about five pounds); the amount you can lift will gradually be increased after that. It may take six months before you can return to heavy manual labor, due to the need for endurance and strength in your shoulder. You may continue to gain strength up to a year or two following surgery.

How Long Will I Need to Wear a Sling?
You will need to wear a sling for about six weeks.

How Soon After Surgery Can I Drive?
You can drive without restrictions at six weeks.

How Soon Can I Return to Sports?
If you’re an athlete, our sports physical therapists can tailor exercises to help you return to your sport safely, maximize your performance, and reduce your risk of re-injury. Full rehabilitation may take four to six months based on the sport. Depending on your level of play, you may also undergo functional return-to-sport strength testing for sports clearance.