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The procedure can be done with a large ("open") incision or with shoulder arthroscopy, which uses small button-hole sized incisions. Description The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint.
These muscles and tendons hold the arm in its "ball and socket" joint and help the shoulder to rotate. The role of the tendons is to hold the powerful shoulder muscles to the shoulder and arm bones. The tendons can be torn from overuse or injury. Your doctor will first check your shoulder with a small camera (arthroscope) to look at the tear and determine if it can be fixed.
The surgeon looks around the entire joint to check the cartilage, tendons, and ligaments of your shoulder. After evaluating the shoulder joint, the surgeon places the camera in the space above the rotator cuff tendons, called the subacromial space.

The surgeon can check the area above the rotator cuff, clean out inflamed or damaged tissue, and remove a bone spur (subacromial spur). If a tear is going to be fixed, the surgeon may perform the surgery with a larger, open incision. Other surgeons use the arthroscope and 1 to 3 additional small poke-holes or smaller incisions to perform the surgery. The additional small incisions allow the surgeon to insert other instruments to repair damaged tissue. The goal is to attach the tendon back to the bone where it tore off. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. At the end of the surgery, the incisions are closed, and a dressing is applied.
Rotator cuff repair can require a long recovery period, especially if the tear was large. In many cases, arthroscopy reduces the need to surgically open the shoulder joint.

In cases of repair, the body still needs to heal after arthroscopic surgery, just as if it were open surgery, so the overall recovery time will still be long. Outlook (Prognosis) The recovery can take anywhere from 3 to 6 months, depending on the size of the tear and other factors.

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