Rotator Cuff Repair

Restoring strength, movement and stability in your shoulder

Rotator cuff repair is a surgical procedure designed to treat tears in the rotator cuff tendons of the shoulder. These tendons play a critical role in stabilising your shoulder and allowing smooth, controlled movement of the arm. When torn, they can lead to significant pain, weakness, and limited range of motion, often affecting your ability to lift or rotate your arm.

Dr Jason Hockings performs arthroscopic (keyhole) rotator cuff repair using modern surgical techniques and personalised planning to help restore shoulder function and relieve pain.

What is the rotator cuff?

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. They work together to keep the head of the upper arm bone (humerus) securely in the shoulder socket while allowing the arm to lift, rotate, and stabilise during movement.

Tears in the rotator cuff can result from:

When might rotator cuff repair be recommended?

Not all rotator cuff tears require surgery. Dr Hockings may recommend a surgical repair if:

Non-surgical treatments (e.g. physiotherapy, cortisone injections) haven’t provided relief
You experience persistent pain or shoulder weakness
Imaging (MRI or ultrasound) confirms a full-thickness or large tear
You are active and need to restore shoulder strength and function
There is a risk of the tear worsening or leading to further damage

What does rotator cuff repair surgery involve?

This type of shoulder replacement may not be suitable if:

Arthroscopic rotator cuff repair, also known as keyhole or minimally invasive surgery, is the preferred approach for treating partial or complete tendon tears within the rotator cuff. This procedure is designed to restore the tendon’s attachment to the head of the humerus (upper arm bone) and improve shoulder strength, stability, and function.

Surgical goals and techniques

During surgery, the torn edges of the tendon are first cleaned and mobilised. Strong sutures are then carefully threaded through the tendon and secured back to the bone using specialised surgical anchors. These anchors are placed within the humerus to hold the tendon in its correct anatomical position, which is vital for proper healing.

Dr Hockings has extensive experience in restoring the tendon’s native position using a range of advanced arthroscopic techniques tailored to the severity and type of tear:

Single-row arthroscopic rotator cuff repair - This technique uses a single row of sutures to reattach the tendon to the bone. It is often suitable for smaller or less complex tears and provides good healing outcomes when the tear pattern allows.
Double-row arthroscopic rotator cuff repair - For larger or more complex tears, a double-row repair may be recommended. This approach places two rows of sutures to better replicate the tendon’s natural footprint on the bone. Research suggests it may reduce the risk of re-tear, particularly in higher-demand patients or when greater stability is needed.
Superior Capsular Reconstruction (SCR) - In cases where the rotator cuff tear is massive and cannot be repaired directly, Dr Hockings may perform a superior capsular reconstruction. This involves inserting a graft to bridge the gap where the supraspinatus and infraspinatus tendons are irreparably torn. This technique can help restore shoulder stability and improve function, even when a direct repair is not possible.

What happens during the procedure?

The entire operation is performed through small incisions using a tiny camera (arthroscope) and specialised instruments. Key steps include:

Insertion of the arthroscope to assess the tear and surrounding joint structures
Cleaning and preparing the torn tendon edges
Passing sutures through the tendon
Reattaching the tendon to the bone using surgical anchors
Performing any additional procedures as needed (e.g. subacromial decompression to relieve impingement or biceps tendon surgery if affected)

The exact technique used will depend on the size and nature of your tear, as well as findings from your MRI or CT scan. Dr Hockings will discuss the best approach for your shoulder based on your individual diagnosis, activity level, and recovery goals.

Surgery duration varies depending on the complexity of the tear and whether additional procedures are required.

Recovery and rehabilitation following rotator cuff repair

Recovery after rotator cuff repair is a gradual process and plays a vital role in the success of your surgery. The healing timeline and rehabilitation plan will vary depending on the size of the tear, the surgical technique used, and your individual goals.

What to expect after surgery

Immediately following your arthroscopic rotator cuff repair:

Sling immobilisation: Your arm will be placed in a sling to protect the repair and limit movement. This is usually worn for the first 4–6 weeks.
Passive movement: Starting the day after surgery, you will begin gentle passive range of motion exercises (where your physiotherapist moves your arm for you). This helps prevent stiffness and maintain joint flexibility while protecting the healing tendon.
Active movement: Around 6 weeks post-op, you’ll begin active range of motion exercises, where you start moving the shoulder on your own under supervision.
Strengthening phase: Between 8 and 12 weeks, a strengthening program will be introduced to rebuild shoulder stability and function.
Long-term recovery: Most patients regain functional shoulder use within 3 to 6 months, though improvements in strength and mobility can continue for up to 12 months or longer.

Structured rehabilitation timeline

Here is a general overview of the rehabilitation phases:

Weeks 0–6

Sling worn to support and protect the shoulder
Passive range of motion exercises only (guided by your physiotherapist)

Weeks 6–12

Gradual introduction of active shoulder movement
Focus on restoring flexibility and joint mobility

Months 3–6

Begin progressive strengthening exercises
Rebuild shoulder endurance, control, and stability

6+ months

Gradual return to overhead activities, work duties, and sports
Timeline varies based on tear severity, occupation, and functional goals

Dr Hockings will guide your progress with scheduled follow-up appointments and adapt your rehabilitation plan to your lifestyle and recovery milestones. Commitment to your physiotherapy program is essential for achieving the best possible outcome.

Potential Risks and considerations with rotator cuff repair

As with any surgical procedure, rotator cuff repair carries some risks. While most patients recover well, it’s important to be aware of the potential complications and factors that may affect healing:

Shoulder stiffness or restricted movement – Sometimes the shoulder may become stiff during recovery, particularly if rehabilitation is delayed or limited.
Re-tear of the tendon – In some cases, particularly with larger or chronic tears, the tendon may not heal fully or may tear again over time.
Infection or bleeding – These are rare but possible complications with any surgical procedure.
Nerve irritation or injury – Although uncommon, nearby nerves can occasionally become irritated or injured during surgery.

Following your post-operative care plan, including sling use, wound care, and physiotherapy, is crucial for protecting your repair and supporting the best possible outcome. Dr Hockings and your care team will monitor your recovery closely and address any concerns that arise during your rehabilitation journey.

During your consultation, Dr Hockings will explain the most appropriate surgical approach based on your condition, anatomy, and individual needs. Many people experience a significant improvement in pain, function, and mobility following hip replacement surgery. Recovery timelines vary depending on the surgical approach and your overall health, but most patients gradually return to walking, driving, and normal activities over the course of several weeks to months.

If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.