The Rotator Cuff
The rotator cuff is a group of four tendons (supraspinatus, infraspinatus, teres minor, subscapularis) that surround the shoulder joint, stabilise the humeral head in the socket, and control rotation and lifting. Tears of the rotator cuff are one of the most common causes of shoulder pain and disability.
Types of Rotator Cuff Tears
Partial tears affect part of the tendon thickness. Full-thickness tears extend completely through the tendon. Tears may be acute (from a specific injury) or degenerative (gradual wear over time). Small and medium tears (<3cm) have the best results from repair. Large (>3cm) and massive tears require more complex reconstruction and may not be fully repairable.
Surgical Repair
Dr Yu performs rotator cuff repair arthroscopically, through two or three small portals around the shoulder. The torn tendon is reattached to the greater tuberosity of the humerus using small anchors and sutures. Arthroscopic techniques minimise soft tissue disruption, reduce post-operative pain, and preserve shoulder joint integrity. Subacromial decompression (removal of any acromial spur and inflamed bursa) is performed at the same time if needed.
Recovery
The arm is protected in a sling for 4–6 weeks to allow the tendon to heal to bone (a biological process that takes 8–12 weeks). Passive physiotherapy begins immediately; active movement commences from 6 weeks. Strengthening begins at 3–4 months. Full recovery of strength and function takes 6–12 months. Return to overhead sport is typically at 9–12 months.
Is Repair Always Possible?
Surgical repair is most successful in: recently torn tendons, smaller tears, and patients under 70 with good tissue quality. Very large or chronic tears with significant tendon retraction and fatty infiltration may not be repairable. In these cases, Dr Yu will discuss alternatives such as superior capsular reconstruction, a tendon transfer, or reverse shoulder replacement (in the elderly).