Rotator cuff repair

What is a rotator cuff repair?

The rotator cuff is a group of tendons that wrap over the top of the shoulder and help lift and rotate the arm. A rotator cuff repair is an operation to reattach a torn tendon back onto the top of the arm bone (the humerus), usually with small anchors and stitches.

It is most often done by keyhole surgery (arthroscopy), through small cuts, though some tears are repaired through a slightly larger open cut. The aim is to reduce pain and improve strength and movement, particularly when lifting the arm.

Not every rotator cuff tear needs surgery. Many tears, especially smaller or age-related ones, are managed successfully with physiotherapy, painkillers and sometimes a steroid injection. Surgery is more often considered for tears caused by a sudden injury, for larger tears, or when good non-surgical treatment has not helped.

It is important to be realistic: the repaired tendon heals slowly and is weak at first, recovery is lengthy, and in a proportion of people the tendon does not fully heal or tears again. Even so, many people still get worthwhile pain relief and better function.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Surgery versus non-surgical care

For many degenerate tears, good physiotherapy gives results similar to surgery. The right choice depends on the tear, your symptoms, age and activity, and should be discussed with a shoulder specialist.

Preparing for your surgery

• Make sure the tear and your symptoms have been properly assessed, usually with a scan (ultrasound or MRI).
• Discuss whether physiotherapy has been tried, and whether surgery is genuinely likely to help your tear.
• Plan for a sling and limited use of the arm for several weeks — arrange help at home and time off work.
• Set up your home so frequently used items are within easy reach of your good arm.
• Tell the team about your medicines, including blood thinners, and any other health conditions.
• Stop smoking if you can, as it is linked to poorer tendon healing.
• Arrange a lift home, as you will not be able to drive for some weeks.

What happens

The operation is usually done under a general anaesthetic, often combined with a nerve block to numb the shoulder and help with pain afterwards. Most repairs are keyhole (arthroscopic), through a few small cuts.

The surgeon cleans up the torn edges of the tendon, then reattaches it to the bone using small anchors and stitches, pulling the tendon back to its proper place. Sometimes a small amount of bone above the tendon is removed to make space. The operation usually takes one to two hours.

Most people go home the same day or after one night, with the arm in a sling. The nerve block can keep the arm numb and heavy for several hours. You will be given pain relief and an early plan for what you can and cannot do with the arm.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The biggest issues are the long recovery and the chance that the tendon does not heal or tears again, which is higher with larger tears, older age and poorer-quality tendon. Smoking and not following the rehabilitation plan also reduce healing. Ask your surgeon how likely your tear is to heal, what their re-tear rate is, and what rehabilitation you will need.

Published figures to discuss

Healing and re-tear rates vary a great deal with the size of the tear, your age, the quality of the tendon and muscle, and how well rehabilitation is followed. The figures below come from pooled studies and are best read as general ranges, not a personal prediction.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is slow and gradual, because a repaired tendon is weak at first and needs time to heal to bone. Most people wear a sling for several weeks, then work through months of physiotherapy to regain movement and then strength.

• Wearing a sling and not actively lifting the arm for several weeks
• Shoulder stiffness that eases with physiotherapy
• Aching, especially at night, in the early weeks
• Slow, gradual return of strength over months
• Needing to pace activities and avoid heavy lifting early on

Aftercare

• Wear the sling exactly as advised, and only do the movements you have been told are safe.
• Do your physiotherapy exercises regularly — this is central to the result.
• Take pain relief as advised, especially before exercises and at night.
• Keep the wounds clean and dry, and follow advice on showering.
• Avoid lifting, pushing, pulling and reaching until cleared to do so.
• Do not drive until you can safely control the car and are off strong painkillers.
• Keep your follow-up and physiotherapy appointments.

• Sling fitted and instructions understood
• Physiotherapy plan and first appointment arranged
• Pain relief ready at home
• Help at home and time off work organised
• Home set up for one-arm use
• Lift home and transport for appointments arranged
• Clinic contact number saved for problems

Scars and how they heal

Keyhole surgery leaves a few small scars around the shoulder, which usually fade well. Open or mini-open repairs leave a slightly larger scar. Scars can be firm and pink at first and settle over months.

⚠ Get urgent help if…

• Spreading redness, heat, swelling or discharge from the wound, or a fever (possible infection)
• Severe or increasing pain not helped by your painkillers
• New numbness, pins and needles or weakness in the hand or arm that does not settle after the nerve block wears off
• Calf pain or swelling, or sudden breathlessness or chest pain (possible clot) — seek urgent help
• The wound opening up
• A sudden pop or loss of movement after a knock or fall (possible re-tear)

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is less pain — especially at night — and improved strength and movement, allowing a return to daily activities and, for some, work or sport. Pain relief often comes before full strength, which returns slowly over months.

Results are not guaranteed. The repaired tendon does not always heal, and even when it does, some stiffness or weakness can remain. A scan may show a re-tear in some people, though not everyone with a re-tear has worse symptoms. Your surgeon should be honest about the likely outcome for your particular tear.

A well-healed repair can last for many years. However, tendons can tear again, especially larger tears, those in older people, and where the tendon and muscle were already poor quality. Following the rehabilitation plan, not smoking, and avoiding heavy strain early on all help the repair last.

Combining with other procedures

A subacromial decompression (removing a small amount of bone above the tendon) is sometimes done at the same time, though the evidence that it adds benefit is mixed. For large tears, a patch or graft may be used to reinforce the repair.

Follow-up & long-term care

You will usually be reviewed in the weeks after surgery to check the wound and progress, with physiotherapy continuing for months. Some surgeons arrange a scan if healing is in doubt. Tell your team if you have a setback, such as a fall or a sudden change in movement.

• Ongoing shoulder strengthening and stretching exercises
• Pacing of heavy and overhead activities, especially in the first months
• Review if pain or weakness returns, which could suggest a re-tear
• Continued attention to general shoulder health and posture

Revision and secondary surgery reality

• A re-tear may lead to further surgery, but not everyone with a re-tear needs or benefits from more surgery.
• Revision repairs are generally less successful than the first operation.
• Large, irreparable re-tears may be managed with tendon transfer or a reverse shoulder replacement.
• Stiffness sometimes needs a manipulation or release procedure.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• A clear, supervised physiotherapy programme with named contacts.
• Written advice on sling use, allowed movements and warning signs.
• Staged review of movement, then strength, over months.
• A plan for what to do if there is a setback or suspected re-tear.
• Realistic, agreed goals for work, driving and sport.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The surgeon's fee and the complexity of the tear
• Whether keyhole or open surgery is used
• Anaesthetic fee, including any nerve block, and theatre/facility time
• Implants used, such as anchors or a patch/graft
• Whether you stay overnight
• The course of physiotherapy afterwards, which is a major part of recovery
• Follow-up appointments and any imaging

• The surgeon's fee and the type of repair
• Anaesthetist's fee and hospital/theatre charges
• Cost of anchors and any patch or graft
• Whether physiotherapy is included and how many sessions
• Follow-up appointments and any scans
• Cancellation policy
• What happens — and who pays — if there is a complication or the repair does not heal

On the NHS? Rotator cuff repair is available on the NHS when criteria are met, often after physiotherapy; private care may be chosen for speed or choice of surgeon.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Has my tear been assessed with a scan, and is it the type that surgery is likely to help?
• Have we tried, or should we try, physiotherapy first?
• How likely is my tendon to heal, and what is your re-tear rate for tears like mine?
• What does the rehabilitation involve, and how long until I can drive, work and lift?
• Will you do a decompression or use a patch, and why?
• What happens if the repair does not heal or tears again?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for rotator cuff repair

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS (RNOH) — Patient's guide to rotator cuff repair NHS (South Tees) — Rotator cuff repair BESS/BOA — Shoulder pain and rotator cuff patient care pathways Retear rates after rotator cuff surgery: systematic review & meta-analysis — BMC Musculoskelet Disord (PMC) Re-tear rates following rotator cuff repair surgery — PMC review Stiffness after arthroscopic rotator cuff repair — PMC Revision surgery for shoulder infection after rotator cuff repair — Healthcare/MDPI

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.