Surgery is recommended to repair a torn rotator cuff when the patient continues to have pain after trying more conservative options, according to the American Academy of Orthopaedic Surgeons. Surgery is also advised if the patient is very active or uses the arms for overhead work or sports.
Other indications that surgery is the best option are as follows: symptoms have persisted for six to 12 months, the tear in the rotator cuff is larger than 3 centimeters, the patient reports weakness and loss of function in the shoulder, or the tear was caused by a recent, acute injury.
The three types of rotator cuff surgeries include open repair, arthroscopic and mini-open repair, explains the American Academy of Orthopaedic Surgeons. Open repair is the traditional method, requiring an incision several centimeters long. The surgeon makes an incision above the shoulder and detaches the muscle to gain access to the tendon. Typically the surgeon will also remove bone spurs from the underside of the acromion, the bony process on the shoulder blade. Arthroscopic surgery is less invasive and is often performed on an outpatient basis. With this procedure, the surgeon inserts an arthroscope or miniature camera through a tiny incision. The mini-open repair involves a smaller incision and smaller instruments than open surgery. Bone spurs can be removed arthroscopically in a mini-open procedure, without detaching the deltoid muscle.