Arthroscopic Rotator Cuff Repair

Who is a candidate?
Rotator cuff repair is recommended for people who have a tear of one or more rotator cuff tendons, usually causing shoulder pain, weakness, and difficulty lifting the arm. Tears can happen from an injury (such as a fall or lifting injury) or develop gradually from wear and tear. Surgery is often considered when symptoms don’t improve with rest, therapy, or injections, and when the tear is large, painful, or causing loss of function.

What does the surgery involve?
The surgery is performed arthroscopically, meaning the surgeon uses a small camera and specialized instruments inserted through tiny incisions around the shoulder. The torn tendon is carefully freed from scar tissue and then re-attached to the bone (the humeral head) using small anchors and sutures. Any inflamed tissue, bone spurs, or other problems inside the shoulder may also be addressed at the same time.

How is this different from a shoulder replacement?
Unlike shoulder replacement, which involves removing and replacing bone and joint surfaces, rotator cuff repair preserves the natural joint. The goal is to restore the patient’s own tendon to its normal position, allowing the muscles to once again stabilize and move the shoulder properly. This surgery is typically offered to patients who still have healthy joint surfaces and do not need a replacement.

What are the potential downsides or risks?
While rotator cuff repair can provide excellent pain relief and improved strength, the repaired tendon needs time to heal back to bone, and there is a risk that it may not fully heal, especially with larger tears or in older patients. Stiffness and persistent weakness can also occur. Recovery takes patience and dedication to rehabilitation.

What is recovery like?
Recovery is gradual. The arm is placed in a sling for the first several weeks to protect the repair while it heals. Early therapy focuses on gentle, guided motion, followed later by strengthening exercises. Most patients begin resuming light daily activities by 6–8 weeks, but full recovery—including return to sports, heavy lifting, or overhead work—often takes 6–12 months. The best outcomes come when patients follow their therapy program closely and give the tendon enough time to heal securely.