What is rotator cuff surgery?

Rotator cuff surgery is the surgical repair of a damaged rotator cuff tendon. The rotator cuff tendons are tough piece of connective tissue that control the motion of your shoulder joint. Your shoulder joint is formed where your upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle) meet. Tendons attach a group of four muscles to these bones to form your rotator cuff. 

Rotator cuff surgery can help restore pain-free range of motion and full function in a damaged shoulder joint.

Rotator cuff tears are common, but not all rotator cuff tears require surgery. Rotator cuff surgery is a major surgery with serious risks, a long recovery, and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having rotator cuff surgery. 

Types of rotator cuff surgery

The types of rotator cuff surgery include:

  • Complete tear or full-thickness tear repair. A complete tear is when your tendon detaches completely from the bone. Your surgeon will reattach your tendon to the bone. 
  • Partial tear repair or debridement. Partial tears often begin with fraying and inflammation of your tendon. Your surgeon may only need to trim and smooth your tendon for this type of repair. 

Other procedures that may be performed

Your doctor may perform other procedures to treat certain coexisting conditions. These include:

  • Bone fracture or dislocation repair. Injuries can cause rotator cuff tears requiring surgical repair of both the tear and the injury. These injuries include a fractured collarbone, a fractured humerus, and shoulder dislocations.
  • Bursectomy or bursa sac repair to treat a damaged bursa sac, which can occur with a damaged tendon. Your bursa sac provides cushioning for your joint.
  • Shoulder replacement to treat osteoarthritis of your shoulder. Shoulder replacement can involve a partial replacement of just one part of your bone or a total replacement of your entire shoulder joint.
  • Soft tissue repair to treat damage to your shoulder muscles.

Why is rotator cuff surgery performed? 

Your rotator cuff is a group of muscles and tendons that surround your shoulder joint. The rotator cuff allows you to lift your arm and rotate your shoulder. Rotator cuff damage is often caused by aging, overuse or injury. This can result in a tendon tear, tendinosis (degeneration), tendinitis (inflammation of your tendon), and bursitis (inflammation of your bursa sac).

Your doctor may recommend surgery to treat a damaged rotator cuff. Your doctor may only consider rotator cuff surgery if other treatment options with less risk of complications have not worked. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on surgery. 

Your doctor may recommend rotator cuff surgery if your tendon tear is: 

  • Caused by a recent injury
  • Causing loss of function in your shoulder
  • Causing symptoms, such as pain, that last for six to 12 months
  • Larger than three centimeters (cm), or a little more than an inch
  • Diminishing your quality of life and nonsurgical management, such as physical therapy, is not working

Who performs rotator cuff surgery?

An orthopedic surgeon will perform your rotator cuff surgery. Orthopedic surgeons specialize in surgical treatment of diseases of the bones and connective tissues.

How is rotator cuff surgery performed?

Your orthopedic surgeon will perform your rotator cuff surgery in a hospital or outpatient surgical setting using one of the following approaches:

  • Minimally invasive surgery is a procedure performed by inserting special instruments and an arthroscope through small incisions in your shoulder. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery. Minimally invasive surgery can involve a faster recovery and less pain than open surgery. This is because it causes less damage to tissues, such as muscle. Your surgeon makes small incisions instead of a larger one used in open surgery. Your surgeon threads surgical tools around tissues instead of cutting through or displacing them as in open surgery.
  • Mini-open surgery uses newer technology and combines minimally invasive arthroscopic techniques with a smaller open procedure. The incision is one to two inches long, which is smaller than a standard open surgery incision. This technique allows your surgeon to make more extensive repairs than are possible with minimally invasive surgery. However, it causes less damage than traditional open surgery because your muscles remain attached during the surgery.
  • Open surgery is performed by making a large incision in the shoulder. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery requires a larger incision and involves more cutting and displacement of muscle and other tissues. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery because it causes more trauma to tissues. Despite this, open surgery may be a safer or more effective method for certain patients or conditions.