Rotator Cuff Surgery: Indications, Types & Recovery

Rotator cuff surgery repairs torn tendons of the four muscles (supraspinatus, infraspinatus, teres minor, subscapularis) that stabilize the glenohumeral joint.

Indications

• Full-thickness tear with persistent pain/weakness >3–6 months conservative care.
• Acute traumatic tear in active patient — early repair favored.
• Partial-thickness >50% failing non-op.
• Associated pathology: Subacromial impingement, biceps tendinopathy, AC joint arthritis — addressed concurrently.

Surgical Approaches

Recovery Timeline

• Sling 4–6 weeks (passive ROM only)
• Active ROM 6–12 weeks
• Strengthening 3–6 months
• Full recovery 6–12 months (varies by tear size, tissue quality, age, compliance)

Outcomes: 80–90% pain relief, functional improvement. Retear risk: 10–40% (size, age, smoking, diabetes).

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Type	Description	Typical Use
Arthroscopic	All-portal, camera + instruments; anatomic footprint repair	Most tears; less morbidity, faster early rehab
Mini-open	Deltoid-splitting incision + arthroscopic prep	Large/massive tears, revision
Open	Full deltoid detachment	Massive/retracted tears, revision, tumor
Superior capsular reconstruction	Graft (dermal allograft/autograft) for irreparable tears	Irreparable, pseudoparalysis, young patient
Reverse total shoulder arthroplasty	Prosthesis reverses ball/socket; deltoid-powered	Cuff tear arthropathy, failed prior, elderly