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HomeIntroductionThe rotator cuff Surgery or non-operative treatment?Who should consider this surgery?Surgical detailsWhen cuff repair cannot be achievedArthrodesisWhen cuff repair is possiblePartial thickness cuff tearsResults of treatmentRehabilitation after cuff surgery

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More Information on Rotator Cuff Surgery.

Last updated Wednesday, January 26, 2005

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Introduction

This is the information which might be shared with patients as they consider rotator cuff repair. Before it can be applied to a specific clinical situation, however, it needs to be tailored to the patient, the problem and the surgeon.

The rotator cuff

The rotator cuff is composed of four tendons that blend together to help stabilize and move the shoulder. Loss of the integrity of the rotator cuff is a common cause of shoulder weakness. Shoulders with large rotator cuff defects have difficulty raising the arm or rotating it out to the side. Strong rotator cuff tissue requires a major force to tear it. Weakened degenerative cuff tissue can be torn easily, even while carrying out activities of daily living.

Surgery or non-operative treatment?

When rotator cuff tears are relatively recent and when a significant force was required to tear the tendon, the chances of regaining shoulder strength by rotator cuff repair surgery are good. Conversely, when the defect is long-standing and occurred without a major injury, the quality and quantity of tissue available for repair may not be sufficient for the restoration of good shoulder function. Thus with long-standing shoulder weakness from rotator cuff defects, a good try at strengthening the remaining muscles may be worthwhile before considering surgical repair. If surgery is undertaken, proper postoperative care is particularly important.

Who should consider this surgery?

Surgical exploration and attempted cuff repair is an option for the patient who understands the limitations of this procedure. Prompt surgical exploration of the rotator cuff is considered for physiologically young patients with acute tears. Repair should be carried out before tissue loss, retraction, and atrophy occur. For tears older than 12 months, a period of stretching and gentle strengthening exercises can indicate the potential for nonoperative management. Exploration is considered for patients with functionally significant weakness from longer-standing tears refractory to nonoperative management, provided that their expectations are realistic.

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