Arthroscopic Rotator Cuff Repair
A torn rotator cuff can make simple movements painful and weaken your shoulder. Arthroscopic rotator cuff repair reattaches the torn tendon to bone, with your preparation, surgery and rehabilitation planned together at MTP Health.
What is arthroscopic rotator cuff repair?
Arthroscopic rotator cuff repair is keyhole shoulder surgery used to repair a torn rotator cuff tendon. The rotator cuff is a group of four muscles and tendons that help lift, rotate and stabilise the shoulder. When one or more of these tendons tears, everyday tasks such as reaching, dressing, sleeping or lifting can become painful and weak.
During surgery, the torn tendon is reattached to the bone using small incisions, a camera and specialised instruments. Suture anchors are commonly used to hold the tendon back onto its attachment point while the body heals the tendon to bone.
Rotator cuff repair is usually considered when shoulder pain and weakness are significantly affecting quality of life and have not improved with appropriate non-surgical treatment. It may also be considered earlier in some larger or traumatic tears, especially where strength and function are clearly affected.
Do you need rotator cuff repair surgery?
Not every rotator cuff tear needs surgery. Some tears can be managed well with physiotherapy, activity modification, pain relief, injections and strengthening of the shoulder blade and surrounding muscles. Surgery is usually considered when symptoms remain intrusive despite a proper rehabilitation program, or when the tear pattern is unlikely to recover well without repair.
You may be more likely to consider surgery if you have ongoing night pain, weakness, difficulty lifting the arm, loss of function, a traumatic tear, a larger tear, or symptoms that are preventing work, sport or everyday activity.
Surgery is rarely urgent, but preparation matters. At MTP Health, we usually prepare patients for a minimum of 4–6 weeks before rotator cuff repair so you are physically stronger, psychologically ready and medically safe enough to undergo the procedure.
Your surgeon will assess your symptoms, shoulder movement, strength, imaging and goals before recommending surgery. The decision depends not only on the scan, but on whether the tear explains your symptoms and whether repair is likely to improve pain, strength and function.
Benefits and risks
What rotator cuff repair can help achieve
- Reduced shoulder pain, especially pain caused by the torn tendon
- Improved shoulder strength over time
- Better ability to lift, reach and perform daily tasks
- Improved sleep once recovery progresses
- Repair of the torn tendon back to bone
- Treatment of other pain generators if needed, such as the biceps tendon, AC joint or subacromial space
- A structured pathway back to work, activity and sport where appropriate
Risks to understand
- Common and temporary: pain, swelling, bruising, stiffness, disturbed sleep and difficulty with hygiene or dressing in the early recovery period
- Uncommon: infection, bleeding, wound problems, nerve or blood vessel injury and blood clots
- Shoulder-specific: frozen shoulder or stiffness, ongoing pain, weakness, failed healing or tendon re-tear
- Procedure-specific: the tear may be too large or tissue quality too poor for a strong repair, and rarely surgery may need to be converted from arthroscopic to open surgery
- Anaesthetic risks: allergic reaction, heart complications, stroke and other medical complications related to your general health
Rotator cuff repair is a quality-of-life operation. A rotator cuff tear is not usually life or limb threatening, so it is important that you understand the recovery commitment and risks before deciding on surgery.
Arthroscopic vs open rotator cuff repair
Most rotator cuff repairs are performed arthroscopically, using small keyhole incisions and a camera to view the shoulder on a screen. This allows the surgeon to inspect the joint, repair the tendon and address other pain sources through smaller wounds.
Open surgery is less common but may be needed for very large, complex or difficult tears. Your surgeon will explain which approach suits your tear, tendon quality and shoulder anatomy.
| Arthroscopic repair | Open repair |
|---|---|
| Performed through several small keyhole incisions | Performed through a larger incision |
| Camera is used to inspect the shoulder joint and subacromial space | Direct open view of the tendon and bone |
| Often used for small, medium and many large tears | May be considered for complex or very large tears |
| Can address biceps, AC joint or subacromial pathology if needed | May be useful when arthroscopic access is not enough |
| Usually smaller wounds and less soft tissue disruption | Recovery still depends heavily on tendon healing and rehabilitation |
How to prepare for rotator cuff repair surgery
Arthroscopic rotator cuff repair is rarely urgent, and outcomes are generally better when you have time to prepare properly. At MTP Health, preparation usually focuses on shoulder strength, general health, medication planning, realistic expectations and organising your home and support after surgery.
It is vital that you work with your physiotherapist to maximise the condition of your rotator cuff, deltoid and peri-scapular muscles before surgery. The MTP Health Shoulder Program is designed to help you prepare your shoulder and understand the rehabilitation process before the operation.
You should also think carefully about the timing of surgery. Recovery affects driving, work, sleep, family commitments, holidays, work trips and busy periods. Planning ahead reduces stress and makes it easier to follow the early restrictions that protect the repair.
Get strong before surgery. Our physiotherapists and exercise physiologists assess your current function and provide a personal program before your operation, so you are ready to begin recovering as soon as you wake from the anaesthetic.
What happens before surgery?
Before surgery, we need to know about all medications you take, especially medicines for diabetes, blood pressure or blood thinning. Some medications may need to be stopped or adjusted up to one week before surgery, depending on your medical history and anaesthetic plan.
If you smoke, it is highly recommended that you stop for as long as possible before surgery. Smoking can affect wound healing and tendon healing, and reducing this risk is part of preparing properly.
Please keep the whole upper limb area, especially the shoulder, free from scratches, cuts, rashes or wounds in the weeks before surgery. Avoid last-minute gardening, heavy outdoor work or anything likely to scratch the skin. If you notice a mark or wound, please tell us early or send a photo. Surgery may need to be delayed if infection risk is increased.
Fasting before surgery
The hospital will contact you in the week of surgery and confirm your arrival time and fasting instructions the day before your operation.
Morning list: stop all food from midnight and stop clear fluids from 5:30am, or two hours before the planned start of the list, whichever comes first.
Afternoon list: stop all food from midnight and stop clear fluids from 11:00am, or two hours before the planned start of the list, whichever comes first.
Acceptable clear fluids include water, see-through apple juice with no bits, or a see-through energy drink such as Gatorade. Clear fluids do not include milk or cloudy juice with bits.
The procedure: what happens during surgery?
You will usually arrive at hospital one to two hours before surgery. A nurse will prepare the shoulder area, which may include shaving the skin and applying a coloured antiseptic solution.
You will then meet the anaesthetic team. Rotator cuff repair is performed under general anaesthetic. If the anaesthetist considers it suitable and you agree, you may also have a regional nerve block to improve pain relief around the shoulder after surgery.
Before the anaesthetic, your surgeon will confirm the operation, joint and side with you. They will check this against your consent form and mark the correct shoulder. The surgical team also performs a formal time-out procedure to confirm your identity, imaging, consent and the marked side before surgery begins.
The procedure is performed under sterile conditions. You are positioned lying on your back before your head and back are raised into a semi-inclined position. Several small incisions are made around the shoulder so the surgeon can insert a camera and instruments.
The torn tendon is assessed, prepared and reattached to the bone. Suture anchors are commonly used to secure the tendon in place. If other structures are contributing to pain, the surgeon may also address the acromioclavicular joint, subacromial space or long head of biceps tendon during the same operation.
The small wounds are closed with dissolvable sutures and adhesive dressings are applied. A sling with an abduction pillow is fitted before you leave theatre. The operation usually takes between 90 minutes and two hours, with additional time for anaesthetic preparation and recovery.
For waiting relatives or partners, it is usually between three and five hours from the time you leave the admissions area to when you return to the ward.
Key point: Surgery brings the tendon back to where it belongs. The tendon still needs to biologically heal to the bone, which is why the first 6–12 weeks of protection and rehabilitation are so important.
What should I expect immediately after surgery?
After the operation, you wake in the recovery room, where you are monitored for approximately one hour. During this time, your surgeon will usually call your relative or support person. It is important they understand this call may be more than four hours after you were taken to theatre because of waiting, anaesthetic and preparation time.
Once you are stable, you will be transferred to the ward to begin post-surgical recovery.
Dressings
The adhesive dressings are water-resistant but not fully waterproof. Please keep them dry, clean and intact until your first follow-up appointment at two weeks. It is normal to see some ooze on the dressings. If the dressings fall off, please reapply new ones. Avoid showering directly onto the wounds and do not submerge the wounds under water.
Cold therapy and Game Ready
If you have been supplied with a Game Ready machine, we advise using program 2 or 3 for up to two hours at a time. You can use it as often as needed during the day, as long as you still complete your rehabilitation exercises. If pain and swelling are well controlled, you do not need to use it.
When supplied by MTP Health, you will usually have the Game Ready machine for two weeks. At the end of this time it will be collected by courier unless you choose to continue the rental.
Length of stay
We call the day after surgery “Day 1 post surgery.” Your aim on this first day is to pass your discharge checks with the hospital physiotherapists and prepare to go home. Some people are safe to go home the day after surgery, while others may need an additional night in hospital.
Surgeon follow-up
Your first post-operative visit is usually with your surgeon at two weeks. This appointment is important for checking wound healing and answering any questions you may have.
Further follow-ups are usually arranged at six weeks, three months and six months after surgery.
Rotator cuff repair recovery and rehabilitation
Your recovery starts as soon as you wake from the anaesthetic. Your fingers, hand and arm may feel numb or weak because of the local anaesthetic or regional block. Once movement returns, you should begin hand pumping and wrist movement exercises as instructed.
The early goal is to keep the repair protected while preventing stiffness in the hand, wrist, forearm and elbow. Shoulder rehabilitation is introduced gradually because the tendon needs time to heal to bone before it can tolerate lifting, loading or strengthening.
Recovery timeline
| Phase | Timeframe | What to expect |
|---|---|---|
| Protection | Weeks 0–6 | Sling worn full time. No shoulder exercises. Focus on fingers, hand, wrist, forearm rotation and elbow range of motion only. |
| Early shoulder movement | Weeks 6–12 | Sling is gradually weaned. Shoulder range-of-motion exercises begin. No lifting, loading or strengthening yet. |
| Strengthening begins | From 12 weeks | Gradual strengthening begins once healing is sufficient to tolerate increasing stress. |
| Functional rebuilding | Months 3–6 | Progressive strengthening, control, endurance and return-to-work or return-to-activity planning. |
| Longer-term recovery | 6+ months | Strength, confidence and shoulder function continue improving. Higher-demand work or sport may take longer. |
Timeframes are a guide. Your surgeon and rehabilitation team will progress you based on the tear size, tendon quality, repair strength, pain, stiffness and your goals.
Pain management
Controlling pain, swelling and inflammation is important in the early recovery period. Cold therapy can be useful. You may be advised to take simple analgesia such as paracetamol and anti-inflammatory medication such as ibuprofen regularly for the first few days, with stronger pain medication used only as needed. Wean off stronger medications as soon as you can safely do so.
Resting and sleeping
Avoid lying or resting on your operated side for at least three months. Many people find it easier to sleep in a reclined position after surgery. If this is not comfortable, lying on your back may be a reasonable compromise.
Sling
Please wear your sling at all times for six weeks after surgery, including when resting or sleeping. The sling should only be removed for prescribed exercises and hygiene routines.
Hygiene care
Hygiene can be challenging in the early stage of recovery. The sling can be removed for washing, but avoid moving the shoulder too much. You can lean forward and towards the operated side to access the armpit and chest. A second sling dedicated for showering can help you complete hygiene routines while keeping the shoulder protected.
Rehabilitation at MTP Health
This is where MTP Health is different. Your rehabilitation is delivered by our physiotherapists and exercise physiologists, working alongside your surgeon. Your plan can begin before surgery and continue afterwards, with everyone working from the same goals and shared clinical record.
Your recovery may be supported by our pre-operative rehabilitation, post-operative rehabilitation, physiotherapy and exercise physiology services.
Rehab protects the repair. The first six weeks are deliberately cautious because the tendon is healing to bone. Doing too much too early can place the repair under stress before it is ready.
When can I return to driving, work and sport?
Return to driving, work and sport depends on your pain, movement, strength, medication use, tear size, repair quality and the demands of the activity. Your surgeon and rehabilitation team will guide your plan.
Driving
Do not return to driving until you can safely control your vehicle in an emergency and are no longer taking strong pain medication. Please discuss your driving plan with your surgeon and check with your car insurance provider.
Office-based work
Desk-based duties such as writing and typing may be possible once you are comfortable and no longer taking strong pain medication. For many people, this is around two weeks, although comfort, transport and sling use can affect timing.
Physical work and lifting
No lifting or loading is allowed for the first three months, not even small everyday loads. More physically demanding work takes longer and should be planned with your surgeon and rehabilitation team.
Sport and exercise
Gradual strengthening and loading can usually begin after three months. Return to sport depends on the sport, whether it involves overhead activity or contact, and how your shoulder progresses. Higher-demand activity is usually measured in months rather than weeks.
Rotator cuff repair surgery cost in Sydney
The cost of rotator cuff repair depends on your private health cover, hospital insurance, surgeon fees, anaesthetist fees, assistant fees, hospital charges, imaging, rehabilitation needs and any excess on your policy.
As always with the health system, the answer is: it depends. At MTP Health, our mission is to simplify healthcare through a better understanding of the system upfront. You can discuss the options specific to you with the team when you see your specialist.
If you are using private health cover, our team will help you understand likely out-of-pocket costs before surgery. Your anaesthetist is an independent practitioner and may charge a separate gap, so we provide their details and recommend checking their quote before committing to surgery.
If surgery is performed through the public system, there may be no out-of-pocket surgical cost, but waiting times can vary depending on hospital access, urgency category and local availability.
Why have your rotator cuff repair at MTP Health?
MTP Health brings together orthopaedic surgeons, physiotherapists and exercise physiologists in one clinic. That matters because rotator cuff repair is not just an operation. It is a long recovery process that depends on preparation, tendon protection, progressive rehabilitation and clear communication.
Honest advice comes first. If your shoulder is better suited to non-surgical care, we will tell you. If surgery is appropriate, we will help you understand what is being repaired, what other pain generators may need to be addressed, how long recovery may take and what you need to do to protect the result.
Your surgeon
Dr Mun Khin Chan
Dr Mun Khin Chan, also known as Dr MK Chan, is an Australian fellowship-trained orthopaedic surgeon specialising in upper-limb and trauma surgery. His clinical interests include shoulder injuries, instability, sports injuries, arthroscopy and shoulder reconstruction.
Dr Chan works alongside MTP Health's physiotherapy and exercise physiology team so your surgical treatment and rehabilitation can be managed as one coordinated plan.
View full profile →Frequently asked questions
What is arthroscopic rotator cuff repair surgery?
Surgery to repair a torn rotator cuff may be offered to patients who have significant shoulder pain and symptoms that are severely affecting quality of life and have not improved with non-operative treatment.
The surgery involves reattaching the torn tendon back to the bone. This is achieved arthroscopically, or through keyhole surgery. After repair, the tendon then needs time to heal to the bone.
During the same surgery, other pain generators such as the acromioclavicular joint, subacromial space or long head of biceps tendon may also be addressed if they are found to be pathological.
How can I best prepare for rotator cuff repair surgery?
Arthroscopic rotator cuff repair is rarely urgent, and results are generally better with proper preparation.
It is vital that you work with your physiotherapist to maximise the condition of your rotator cuff, deltoid and peri-scapular muscles before surgery. This helps improve your post-operative rehabilitation and recovery.
The MTP Health Shoulder Program is designed to help with this preparation. We usually prepare patients over a minimum period of 4–6 weeks so they are psychologically ready, physically stronger and medically safe enough for the procedure.
You should also consider how the timing of surgery may affect family events, holidays, work trips and busy work periods. There are some exceptions where your surgeon may need to reduce the preparation time, but this is not common and will be explained if it applies to you.
What happens before arthroscopic rotator cuff repair surgery?
We need to know about all your medications, especially medicines for diabetes, blood pressure or blood thinning. Some may need to be stopped or adjusted up to one week before surgery.
If you smoke, it is highly recommended that you stop for as long as possible before surgery to support better healing and reduce risk.
Please keep the whole upper limb area, especially the shoulder, free from scratches in the weeks before surgery. Avoid last-minute gardening or activities that may break the skin. If this occurs, please tell us or send a photo, as it may increase infection risk and surgery may need to be delayed.
The hospital will contact you in the week of surgery and confirm your arrival and fasting instructions the day before your operation.
What happens during arthroscopic rotator cuff repair surgery?
You will arrive at hospital between one and two hours before surgery. A nurse will prepare the shoulder area and you will meet the anaesthetic team.
The operation is performed under general anaesthetic. If suitable and agreed, a regional nerve block may also be used to improve pain relief after surgery.
Your surgeon will confirm the operation, joint and side with you before marking the shoulder. The team then performs a formal time-out check to confirm your name band, imaging, consent form and surgical site all match.
Several small incisions are used to insert a camera and instruments into the shoulder. The torn tendon is repaired back to bone, and other pain sources such as the biceps tendon, AC joint or subacromial space may be treated if required.
The wounds are closed with dissolvable sutures, dressings are applied and a sling with an abduction pillow is fitted. Surgery usually takes between 90 minutes and two hours, with extra time before and after for anaesthetic and recovery.
What should I expect immediately after arthroscopic rotator cuff repair surgery?
After surgery, you wake in the recovery room where you are monitored for approximately one hour. Your surgeon will usually call your relative or support person during this time.
Once stable, you will be transferred to the ward. Your dressings should be kept dry, clean and intact until your first follow-up appointment at two weeks. It is normal to see some ooze on the dressing.
If you have a Game Ready machine, you may use it for swelling and pain control as advised. Some people go home the day after surgery, while others may need an additional night in hospital.
Your first surgeon follow-up is usually at two weeks, with further reviews at six weeks, three months and six months.
What is my rehabilitation following arthroscopic rotator cuff repair surgery?
Your recovery starts once you are awake from the anaesthetic. Your upper limb, especially the fingers, may feel numb or weak due to local anaesthetic or a regional block.
Once movement returns, you should begin hand pumping and wrist movement exercises. Your goal on Day 1 is to be safe for discharge home, including walking safely and managing basic tasks in the sling.
For the first six weeks, there are no shoulder exercises. You focus on finger, hand, wrist, forearm rotation and elbow range-of-motion exercises only. There is no lifting or loading.
From six to 12 weeks, shoulder range-of-motion exercises begin and the sling is gradually weaned. You should not push through pain, and there is still no lifting, loading or strengthening.
From 12 weeks onwards, strengthening begins gradually. The repair needs time to heal before it can withstand increasing stress, so rehabilitation must progress carefully.
When can I return to driving, work and sport after arthroscopic rotator cuff repair surgery?
Office-based work such as writing and typing can often restart once you are comfortable and no longer taking strong pain medication. For many people, this may be around two weeks.
No lifting or loading is allowed for three months, not even small everyday loads. Returning to physical work takes longer and should be planned with your surgeon and therapist.
Gradual strengthening and lifting can usually begin after three months. Return to sport depends on the sport, the repair and your progress.
You should not return to driving until you can safely control your vehicle in an emergency and are no longer taking strong pain medication. Please discuss this with your surgeon and check with your car insurance provider.
What are the risks of arthroscopic rotator cuff repair surgery?
Rotator cuff repair is a quality-of-life operation. A rotator cuff tear is not usually a life or limb threatening condition, so it is important to understand the risks before deciding on surgery.
Risks include scar, infection, bleeding, stiffness or frozen shoulder, blood clots, ongoing pain, weakness, damage to nerves, blood vessels, tendons, muscles, bone or joint, unsuccessful repair and unsuccessful tendon healing.
Some repairs may fail because the tendon quality is poor or the tendon has retracted too far. In rare cases, surgery may need to be converted from keyhole surgery to open surgery because of bleeding, swelling or tear size.
Anaesthetic and medical risks can include allergic reactions to medications, heart complications and stroke. Your surgeon and anaesthetist will discuss your individual risk profile before surgery.
Can a rotator cuff tear heal without surgery?
Some people with rotator cuff tears improve without surgery, especially when symptoms are mild, the tear is smaller, or the main issue is pain rather than major weakness. Physiotherapy, strengthening, activity modification and injections may help many patients manage symptoms.
However, a full-thickness tendon tear does not always heal back to bone by itself. If pain, weakness and loss of function continue despite good non-surgical care, surgery may be discussed.
How long does rotator cuff repair recovery take?
Recovery is usually measured in months rather than weeks. The sling is typically worn for six weeks, shoulder movement begins gradually after that, and strengthening usually starts from around 12 weeks.
Many people continue improving for six months or longer. Larger tears, physically demanding work and overhead sport can take longer.
Rotator cuff repair consultations across Sydney
North Shore Health Hub, Level 4, Suite 401, 7 Westbourne St, St Leonards NSW 2065
St Leonards consulting →173 Warringah Road, Beacon Hill NSW 2100 — serving the Northern Beaches
Beacon Hill consulting →Also consulting at Gosford, Wahroonga, Castle Towers and Tamworth.
Talk to a surgeon about your shoulder
Book a consultation to find out whether rotator cuff repair is right for you — and if it is not, to leave with a clear plan for the most suitable next step.
Book a ConsultationPrefer to talk? Call (02) 9437 9794 · GP & physio referrals: referrer information
- American Academy of Orthopaedic Surgeons, OrthoInfo — rotator cuff tears and arthroscopic rotator cuff repair surgical treatment guidance.
- Current clinical guidance and peer-reviewed literature on arthroscopic rotator cuff repair, tendon healing, sling use and staged rehabilitation.