What Is Rotator Cuff Repair Surgery?
The goal of rotator cuff surgery is to ease pain and regain shoulder strength after a rotator cuff injury. It usually involves reattaching the tendon to its original site on the top of the upper arm bone. Surgeons may also remove loose fragments of tendon, bone spurs, inflamed tissue, and other debris from the joint.
Torn rotator cuff surgery is one of the most common procedures in the country. With increasingly sophisticated technology, it is almost always an outpatient procedure. That means you'll go home the same day, without a hospital stay.
Doctors can commonly use arthroscopic surgery for rotator cuff repair, which is a minimally invasive procedure. Rotator cuff surgery can also be performed with a traditional open surgery, using larger incisions. Your doctor can tell you which rotator cuff repair technique is best for you.
Rotator cuff repair is still considered major surgery, even when doctors use minimally invasive methods.
Types of rotator cuff repair surgery
There are several types of rotator cuff surgery. Your doctor will take many factors into consideration in recommending which method is right for you.
The type of repair depends on:
- The quality of your tendon tissue and bone.
- The size and shape of your shoulder.
- The size of the tear.
The three types of rotator cuff surgery are:
- Arthroscopic repair — Surgeons insert a small camera and tiny surgical instruments into the shoulder joint, viewing the operation through a video monitor. They use small incisions and don’t have to split the deltoid muscle. Arthroscopy is by far the most common type of rotator cuff repair used today.
- Open repair — Traditional surgery with incisions several centimeters long. Surgeons split or move the large deltoid muscle to get access to the torn tendon. Open repair may be the best method for certain types of rotator cuff tears.
- Mini-open repair — A hybrid technique using both arthroscopic and open techniques. This option allows surgeons to remove damaged tissue or bone spurs with an arthroscope. They then repair the rotator cuff during the open part of the surgery, using larger incisions.
Conditions we treat with rotator cuff repair surgery
During surgery for a rotator cuff tear, your surgeon may also take care of other problems.
They may be able to fix:
- Biceps tendon tears.
- Bone spurs.
- Osteoarthritis.
- Soft-tissue tears.
- Inflamed tissue, such as bursa or synovitis.
Why Would I Need Rotator Cuff Repair Surgery?
A torn rotator cuff is a common injury. It can lead to pain, difficulty moving your arm, and a decreased quality of life. Even something as simple as getting dressed can become a challenge. Increased pain at night or while sleeping is also a common symptom.
Rotator cuff surgery can help bring function back to your arm and shoulder. It can decrease pain and let you get back to your favorite activities.
Who’s a candidate for rotator cuff repair surgery?
You might be a good candidate for rotator cuff repair surgery if:
- Conservative treatments like physical therapy and medication haven’t worked.
- Symptoms have lasted six to 12 months.
- The tear is large and complete.
- You can no longer lift your arm or perform simple tasks like getting dressed or reaching something on a high shelf.
- You had a sudden, severe injury, and now have a change or loss of function.
- You need full shoulder strength for your job or activities.
- You’re in good overall health, without muscle atrophy (wasting away).
You’re more likely to have poor results from rotator cuff repair surgery if:
- The rotator cuff was weak or torn before your injury.
- The muscles around the rotator cuff were weak before the surgery.
- You are over age 65.
- You don’t follow the care instructions and physical therapy exercises after the surgery.
- You smoke.
- There is significant atrophy around your rotator cuff muscles.
Alternatives to rotator cuff repair surgery
A completely torn rotator cuff cannot heal on its own.
However, if you have only a partial tear, you may not need surgery. Physical therapy and rest can strengthen the shoulder and increase your range of movement. But even with treatment, a minor tear can still take several months to heal.
Your doctor may suggest you try other treatments before recommending surgery.
Conservative treatments include:
- Corticosteroid injections.
- Electrical stimulation of the nerves and muscles.
- Icing the sore area.
- Anti-inflammatory medicine.
- Physical therapy.
- Resting the shoulder and avoiding overhead movements.
What Are the Risks and Complications of Rotator Cuff Repair Surgery?
Overall, rotator cuff surgery is a safe procedure. However, every surgery has some risks.
These include:
- Allergic reactions to anesthesia.
- Breathing problems.
- Bleeding.
- Blood clots.
- Infection.
Specific risks of rotator cuff repair surgery include:
- Detachment of the deltoid muscle — Rarely, deltoid detachment can happen, particularly after open surgery, if doctors detach the shoulder muscle. They stitch it back into place after the procedure, but if it’s not protected, it can detach again.
- Nerve damage — Very rarely in the nerves of the shoulder.
- Stiffness — Losing motion in your shoulder can happen in a small number of patients and is more likely to happen if you don’t stick to a physical therapy routine.
- Tendon re-tear — There is always the chance of the tendon not healing or re-tearing after the repair. If the original tear was large, or your tendon tissue is thin, your risk of a re-tear is greater.
What Should I Expect from Rotator Cuff Repair Surgery?
Most rotator cuff surgeries are outpatient procedures. That means you’ll go home the same day. Your doctor will give you specific instructions, but here are some overall points to remember about your surgery.
Before: how to prepare for rotator cuff repair surgery
Your surgeon and nurse will give you specific instructions on how to get ready for your surgery. They may ask you questions like:
- Are you or could you be pregnant?
- Are you taking any prescription drugs?
- Are you taking over-the-counter (OTC) medicine?
- Are you taking supplements or herbs you bought without a prescription?
- Have you been drinking more than one or two alcoholic drinks per day?
The week before your surgery, you may need to:
- Arrange for help with basic household tasks like cooking and cleaning for a few days.
- Have someone to drive you home and listen to your surgeon’s post-op instructions with you. It helps to have another person hear and remember the information.
- See the doctor who treats you for diabetes, heart disease, or any other chronic condition you may have.
- Shift your work schedule — You may need to work from home, perform a sedentary job while healing, or wait until your doctor clears you to drive, depending on your job responsibilities.
- Stop smoking — Smoking can interfere with wound and bone healing and can increase the risk of complications after surgery.
- Stop taking blood-thinning medicines — These may include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin or clopidogrel, or other medicines. Your doctor will let you know how many days before your surgery you should stop taking the blood thinners.
- Tell your surgeon if you develop any illness before your surgery — This might include COVID-19, a cold, flu, fever, herpes outbreak, or other illness. Some minor illnesses may not interfere with surgery while others may require you postpone surgery.
On the night before or the day of the surgery:
- Arrive on time to the hospital.
- Bring a friend or loved one to drive you home.
- Follow the instructions your doctor gives you about when to stop eating and drinking before the procedure.
- Take any essential medications with a small sip of water.
How long does rotator cuff repair surgery take?
The surgery itself usually takes about an hour or two. But the time can vary depending on what type of rotator cuff surgery you have, and if there are any complications. There is also time needed for anesthesia, for the surgical team to position and drape, and time required to perform wound closure, place the dressing, and transfer off the operating table. While this time is not related to the surgery, it can extend the entire time in the operating room.
During your rotator cuff repair surgery
Depending on what type of rotator cuff surgery you have, the specifics may vary. But the procedure usually involves the following steps.
Your doctor will:
- Give you anesthesia through an IV. You will most likely have general anesthesia, which means you’ll be asleep and won’t feel pain. You may also have regional anesthesia, so your arm and shoulder will be numb, and you’ll feel less pain after the surgery.
- Make an incision over the shoulder. With arthroscopic repair, doctors will insert a small camera into the shoulder joint and there will be other small incisions for the instruments needed to perform the repair.
- Detach or split one of the deltoid muscles to see the torn tendon (only in open surgery).
- Remove loose fragments of tendon, bursa, frayed tissue, or other debris from the space where the rotator cuff moves. Doctors call this procedure debridement.
- Make room for the rotator cuff tendon so it’s not pinched. The surgeon may need to remove bone spurs or shave bits of bone to improve the space.
- Sew the torn edges of the tendon back together.
- Attach the tendon to the ball portion of the upper arm bone.
- Remove the surgical instruments and sew up the incision.
Recovery after rotator cuff repair surgery
It’s important to know what will happen — and what you need to do — after your rotator cuff surgery. You should keep in mind that the entire recovery process from rotator cuff surgery is a long one. The majority of recovery occurs between four to six months, but full recovery can take up to a year. Due to this period of time, you will be advanced to different stages of range of motion and strengthening.
Immediately after the surgery
After your surgery, you will feel some pain. It’s a normal part of the healing process. Your doctor will prescribe you pain medicine. This is usually a combination of non-narcotic and narcotic medications.
It’s important to “stay ahead of the pain” when recovering. That means you should take the medicine before the pain becomes overwhelming. The nurses will instruct you how to take the medications.
In most cases, you will go home the same day as your surgery. Doctors and nurses will check on you as you come out of anesthesia. Someone else will need to drive you home.
You will go home with your arm in a sling. You may need to wear the sling for four to six weeks after your surgery. While your arm is in the sling, you do not have finger, hand, and wrist range of motion restrictions. You will usually not have elbow range of motion restrictions as well.
When you get home
It’s important to follow your doctor’s directions for pain control and rest. Don’t push yourself too hard or you can end up hurting your shoulder.
Here are some ways to care for yourself at home.
- Don’t drive right away — Your doctor will tell you when it’s safe to drive. That may be in a few weeks or when you no longer need the sling.
- Ice — Put a cold pack on your shoulder for 10 to 20 minutes at a time, every hour or so. This will help reduce swelling and pain. It is also important to take breaks so that you do not get freezer burn.
- Rest — Your body is healing and needs lots of sleep. Make sure you rest when you feel tired. You will need to sleep in the sling for the first four to six weeks depending on the recommendation of your surgeon. While you can sleep flat, you may feel more comfortable propping yourself up with pillows or sleeping in a reclining chair.
- Return to work only when your doctor says it’s ok — For a desk job, that might be within one to two weeks. For more active work or physically strenuous jobs, it might be a few months. Your doctor will discuss strategies for work with restrictions.
- Use your sling — Keep your arm in the sling when you stand or walk. You can loosen it when you sit or lie down. You may take your sling off for showering, dressing, or sitting in a controlled environment with your arm resting on your lap. It’s also ok to support your arm on a pillow.
- Walk — Movement helps with blood flow, which helps you heal. Immediate finger and hand range of motion right away will help with blood flow and controlling swelling. Walking will also help prevent constipation and pneumonia. Both are common side effects of surgery.
Physical therapy
One of the most important parts of healing from rotator cuff repair surgery is to keep up with physical therapy exercises. If you don’t, you’re more likely to have a poor result from the surgery.
Here are the main stages of therapy:
- Immobilization — The rotator cuff needs protection while the tendon heals. You should use a sling and avoid using your shoulder during the period of sling wear. The sling wear period can be four to six weeks depending on the instructions of your surgeon. Your surgeon will determine the total amount of sling wear depending on the nature of your surgery. How long you need the sling depends on how severe your tear was and what
- Passive exercise — Your arm muscles will be weak from nonuse after several weeks in a sling. Your physical therapist can help you improve your range of motion with gentle exercises. They will support your arm and move it in different positions. When you start passive exercises will be determined by your surgeon and may start during the period of sling wear.
- Active exercise — In another month or two, you’ll move on to exercise against gravity without manual assistance of your physical therapist. These will gradually increase your strength and precision of movement.
- Strength exercise – When your motion is symmetric to the other shoulder, the physical therapist will then progress to gentle, progressive strengthening.
When to call your doctor about rotator cuff repair surgery post-op problems
You will have follow-up appointments after your surgery. It is very important to go to these checkups and keep your doctor informed about your progress.
You should call the doctor right away if you have any of the following symptoms after your surgery:
- A fever greater than 101° degrees Fahrenheit.
- Bluish color in your fingers or hand.
- Difficulty breathing.
- Increased pain or pain that doesn’t go away with pain medicine.
- Numbness or tingling in your fingers or hand.
- Pus draining from the incision.
- Red streaks coming from the incision.
- Severe nausea or vomiting.
- Swelling, warmth, or redness around the incision.
- Your incision bleeds through your bandage. It is normal to have pinkish drainage from fluid placed in your shoulder during surgery. This should decrease over several days.
- Your incision is still bleeding three days after your surgery.
- Your stitches become loose or open.
What’s the prognosis for rotator cuff repair surgery?
Surgery to repair a torn rotator cuff usually relieves shoulder discomfort successfully. After your full recovery, your shoulder will likely be less painful with better function than it was before the surgery. Most people also have improved shoulder strength.
However, sometimes people don’t return to their full shoulder strength. The rotator cuff can sometimes not fully heal although most patients experience significant improvement of symptoms even if the rotator cuff does not heal.
You should know that the recovery period for rotator cuff surgery can be lengthy. It may take from four to six months up to a year, depending on the size and severity of the tear. It’s important to be patient and follow your doctor’s orders and physical therapy routine. You will, however, be moving your shoulder during this time and your progress will be advanced in a staged fashion.
Your doctor will tell you when you can return to work or play sports. You should expect it to take months instead of weeks. The time depends on what type of rotator cuff surgery you had, and how severe your tear was.
By UPMC Editorial Staff. Last reviewed on 2026-05-28.
