There are three bones that are involved in the shoulder: the humerus, the scapula, and the clavicle. The rotator cuff is made up of a group of four tendons and muscles that surround the shoulder joint. These muscles are the subscapularis, the supraspinatus, the infraspinatus, and the teres minor, and together they work to stabilize the joint and move the arm. A fluid-filled sac or bursa protects the tendons of the rotator cuff and allows them to slide smoothly as the arm moves.

Rotator cuff tears occur when at least one of the cuff tendons is torn, fully or partially detaching the muscle from the humerus. These tears are most commonly caused by either cumulative injury through repetitive motion such as in throwing sports and weight lifting, or by a sudden or acute injury such as a fall. There are two main categories of rotator cuff tears: partial tears and full tears; this animation discusses the repair of a fully torn rotator cuff. Please see our Partially Torn Rotator Cuff animation for additional information.

Surgical repair techniques vary depending upon your surgeon’s preference, the severity of your tear, the tissue quality, and your individual anatomy. These techniques include open repair, mini-open repair, and arthroscopic repair. This animation will explain the common arthroscopic repair.

Depending upon your preference and that of the anesthesiologist, you will be put under general anesthesia and/or a nerve block. Your surgeon will make one or two small incisions around the shoulder joint. Next, a cannula will be inserted into the incision and saline solution will be injected in order to expand the joint to allow the placement of a small camera or arthroscope, and surgical instruments. Once placed, the arthroscope will display images onto a video monitor and your surgeon will use these images for guidance during the procedure. In order to provide more room to protect your repaired tissue, many surgeons will remove bone spurs from the underside of the bone above the joint, known as the acromion, which is part of the scapula. Your surgeon will remove severely damaged or scarred tissue from your torn tendon. Implants called suture-anchors are then placed in order to secure the repaired tissue to the bone. Your surgeon will then pull the tissue over the top of the head of the humerus for reattachment.