Torn rotator cuff surgery should seldom be the first option in the treatment of a rotator cuff tear.

Torn rotator cuff surgery is generally only undertaken in those cases that have not responded to non surgical treatment.

There is no evidence that torn cuff surgery outcomes are improved by early surgical intervention. Most surgeons should at least consider a non surgical options first.

That is true in most cases but if the tear is caused by a major trauma or is known to be a significantly large tear then rotator cuff tear surgery may be considered immediately.

If rotator cuff repair surgery is eventually recommended what can you expect to happen?

That is a question I get asked a lot. I hope in this section to be able to outline what the surgical options are and how your rotator cuff tear surgery is likely to be performed.

Surgery is performed to repair the tendon of the rotator cuff and reattach it to the humeral head of the upper arm bone.

There are other aspects to most rotator cuff repair surgery but that is the main aim. This can be accomplished in a number of different ways depending upon your surgeon, your anatomy, the size of the tear, quality of the tendon etc.

Ultimately the choice of repair technique can come down to something as simple as your surgeons experience with each method.

The comforting thing to know is that regardless of which method is used studies have shown very similar results in terms of pain relief, restored strength and patient satisfaction.

Torn rotator cuff surgery has three common techniques, open repair, mini open repair and arthroscopic rotator cuff repair. It is very important to discuss with your surgeon the method of rotator cuff repair surgery he is considering.

This is because a surgeon's results can vary markedly by technique. An expert in open surgery should, for example, be able to complete an arthroscopic rotator cuff repair but there is no guarantee they would be as good.

Open Repair

< - - - Open repair incision

Open repair torn rotator cuff surgery is performed without arthroscopy.

The surgeon makes an incision over the shoulder and detaches the deltoid muscle to gain access to the torn rotator cuff.

The incision is typically several centimeters long.




Open repair was the first technique employed in torn rotator cuff surgery.

Gradually, over the years, the introduction of new technology and improved surgeon experience has led to the development of less invasive surgical procedures.

Although a less invasive procedure may be attractive to many patients, open repair does restore function, reduce pain, and is durable in terms of long-term relief of symptoms.

Mini-Open Repair

Mini open repair the black line showing the proposed incision

As the name implies, mini open repair in torn rotator cuff surgery is a smaller version of the open technique. The incision is typically 3 cm to 5 cm in length.

This technique also incorporates arthroscopy to visualize the tear and assess and treat damage to other structures within the joint. It removes the need to detach the Deltoid muscle.

Mini open repair can generally be performed on an outpatient basis. Currently, this is one of the most commonly used methods of torn rotator cuff surgery.

Results for mini open rotator cuff repair surgery have been equal to those for open repair. The mini open repair technique has also proven to be durable over the long-term.

Arthroscopic rotator cuff repair

This technique uses multiple small incisions (portals) and arthroscopic technology to visualize and repair the rotator cuff.

All-arthroscopic repair is usually an outpatient procedure.

The technique is the most challenging for the surgeon.

It appears that the results are comparable to those for mini-open repair and open repair.

There are certainly advantages to arthroscopic rotator cuff repair. Each step toward less invasive surgery has benefited the patient by, decreasing pain from surgery, decreasing postoperative stiffness, decreasing surgical blood loss and decreasing length of stay in the hospital.

Perhaps the greatest benefit of arthroscopic rotator cuff repair is an easier rehabilitation. A proper program of rotator cuff physical therapy is vital to a successful recovery.

Torn rotator cuff surgery performed via an arthroscopic rotator cuff repair allows for much easier rotator cuff physical therapy. This in turn leads to a better recovery and less post operative pain.

Each technique has similar results in terms of satisfactory relief of pain, improvement in function, and patient satisfaction.

Less invasive surgery results in an easier rehabilitation process and less postoperative pain.