Your treatment options for a rotator cuff tear will depend on several factors, including the cause and type of tear, your age, what types of activity you use your shoulder for, and what your goals are for future function. Your doctor may recommend surgery to repair your rotator cuff tear if:
- Your shoulder pain continues despite nonsurgical treatments
- You have a complete tear (not a partial tear)
- Your job requires overhead activity such as lifting or reaching
- You are an athlete who wants to return to a high level of performance
Our goal is to alleviate your shoulder pain and restore your shoulder strength and range of motion, so you can get back to the activities and sports you enjoy.
Types of 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.
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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 Capsular 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.
Common Questions About Rotator Cuff Surgery
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 1-2 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.
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 a tear you have, 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.
Between 6 and 12 weeks after surgery you can do light lifting (for example, about 5 pounds); the amount you can lift will gradually be increased after that. It may take 6 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 6 weeks.
How Soon After Surgery Can I Drive?
You can drive without restrictions at 6 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.
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2020–2021.