Michael Fu, MD - HSS Orthopedic Surgeon and Shoulder Specialist
Rotator cuff repair surgeon in NYC & New Jersey
Considering surgery for a shoulder rotator cuff tear?
Dr. Michael Fu is a shoulder specialist orthopedic surgeon at Hospital for Special Surgery (HSS) treating patients in NYC and New Jersey. If you have been diagnosed with a full-thickness tear, have shoulder pain at night, weakness lifting your arm, symptoms that have not improved with physical therapy or injections, or an acute traumatic tear after an injury, schedule a consultation to review whether surgical repair is appropriate.
When does a rotator cuff tear need surgery?
Not every rotator cuff tear requires surgery. Some partial tears, degenerative tears, or mild symptoms can improve with time, physical therapy, activity modification, or injections.
Surgery may be considered when a rotator cuff tear causes persistent pain, weakness, loss of function, or difficulty sleeping despite nonsurgical treatment. Surgery may also be recommended earlier for traumatic full-thickness tears, especially in active patients or patients who have significant weakness.
You may benefit from a rotator cuff consultation if you have:
A full-thickness rotator cuff tear
Shoulder pain at night or pain that interferes with sleep
Weakness lifting the arm overhead or away from the body
A traumatic tear after a fall, injury, or shoulder dislocation
Symptoms that have not improved with physical therapy, injections, or time
A tear that is enlarging or causing progressive loss of function
Why see a shoulder specialist for rotator cuff repair?
Rotator cuff tears can vary dramatically from patient to patient. A small partial tear is very different from a large full-thickness tear, a traumatic tear, or a chronic retracted tear with muscle changes.
As a shoulder specialist, I focus on understanding the full pattern of the problem — not just whether the MRI shows a tear. Important factors include the size of the tear, tendon quality, amount of weakness, how long the tear has been present, whether the injury was traumatic, and whether other shoulder problems are also contributing to pain.
This helps determine whether surgery is appropriate, whether the tear is repairable, and whether related problems such as biceps tendon disease, bone spurs, impingement, or AC joint arthritis should be treated at the same time.
Understanding Rotator Cuff Injuries
The rotator cuff is a group of four tendons that surround the shoulder joint. These tendons help lift and rotate the arm and keep the shoulder centered during movement.
A rotator cuff tear can occur gradually from wear and tear over time, or suddenly after an injury such as a fall, lifting injury, or shoulder dislocation. Common symptoms include pain on the side of the shoulder, pain at night, weakness, difficulty lifting the arm, and pain with overhead activities.
Some patients can manage a rotator cuff tear without surgery. Others continue to have pain, weakness, or functional limitation and may benefit from surgical repair.
Other problems often treated during rotator cuff repair
Rotator cuff tears often occur along with other sources of shoulder pain, including biceps tendon inflammation, bone spurs, shoulder impingement, and arthritis of the AC joint.
During arthroscopic rotator cuff repair, I evaluate the entire shoulder. If these associated problems are contributing to pain, they can often be treated during the same surgery. This may include biceps tenodesis, removal of bone spurs, subacromial decompression, or distal clavicle excision for painful AC joint arthritis.
Not every patient needs these additional procedures. The decision is based on your symptoms, physical exam, MRI findings, and what is seen during surgery. The goal is to treat the full source of pain rather than repairing the tendon while leaving another pain generator untreated.
How is arthroscopic rotator cuff repair performed?
Rotator cuff repair is usually performed arthroscopically through small incisions around the shoulder. A small camera is inserted into the shoulder, allowing the surgeon to view the rotator cuff, biceps tendon, cartilage, labrum, bone spurs, and other structures.
The torn rotator cuff tendon is repaired back to the bone using small anchors and sutures. The goal is to restore the tendon to its attachment site so that it can heal back to the bone over time.
If other painful problems are present, they may be treated during the same procedure. For example, inflamed bone spurs can be removed, the biceps tendon can be treated with biceps tenodesis when appropriate, and painful AC joint arthritis can be treated with distal clavicle excision.
Arthroscopic view of a shoulder rotator cuff tear, before and after repair.
Advantages of Arthroscopic Repair
Arthroscopic rotator cuff repair allows the tendon to be repaired through small incisions with minimal disruption of the surrounding soft tissues.
Potential benefits include:
Smaller incisions
Direct visualization of the entire shoulder joint
Ability to treat associated biceps, impingement, or AC joint problems
Less soft-tissue disruption compared with traditional open surgery
A structured path toward pain relief, improved strength, and return of function
The main goal of surgery is to relieve pain, improve shoulder function, and give the torn tendon the opportunity to heal back to the bone.
Recovery after rotator cuff repair
Recovery after rotator cuff repair is gradual. The tendon needs time to heal back to the bone, so the early phase of recovery focuses on protecting the repair.
Most patients wear a sling for several weeks after surgery. Physical therapy typically progresses in stages, beginning with gentle motion and later advancing to strengthening. Light daily activities often improve within the first few months, but full recovery can take several months depending on the size of the tear, tissue quality, and the demands of the patient’s work or sports.
For more detail, please read our guide on what to expect in your recovery after shoulder rotator cuff repair.
Frequently Asked Questions
Does every rotator cuff tear need surgery?
No. Many rotator cuff tears can be treated without surgery, especially if symptoms are mild and strength is preserved. Surgery is more often considered for full-thickness tears, traumatic tears, persistent night pain, weakness, or symptoms that do not improve with nonsurgical treatment.
Can a full-thickness rotator cuff tear heal without surgery?
A full-thickness tear generally does not heal back to the bone on its own. However, some patients can still function well without surgery if pain is controlled and strength is acceptable. The decision depends on your symptoms, activity level, tear size, tendon quality, and goals.
When should a traumatic rotator cuff tear be evaluated?
A traumatic rotator cuff tear should be evaluated promptly, especially if it causes significant weakness or difficulty lifting the arm. Acute full-thickness tears may be more repairable earlier, before the tendon retracts or the muscle changes over time.
Can biceps tenodesis be done during rotator cuff repair?
Yes. The long head of the biceps tendon is a common source of pain in patients with rotator cuff tears. If the biceps tendon is inflamed, unstable, or partially torn, biceps tenodesis may be performed during the same surgery.
Can AC joint arthritis be treated during rotator cuff repair?
Yes. If the AC joint is a significant source of pain, distal clavicle excision can sometimes be performed during the same arthroscopic procedure. This is only recommended when the AC joint appears to be contributing meaningfully to the patient’s symptoms.
How long does recovery take after rotator cuff repair?
Recovery depends on the size of the tear and the type of repair. Many patients resume light daily activities within a few weeks, but strengthening and return to sports or heavier activity usually takes several months. Larger tears generally require a longer recovery.
Schedule a Rotator Cuff Consultation
If you have a full-thickness rotator cuff tear, persistent shoulder pain, night pain, weakness, or symptoms that have not improved with physical therapy or injections, a consultation can help determine whether surgery is the right option.
Dr. Michael Fu sees patients for rotator cuff tears and shoulder surgery consultations in New York City and New Jersey.
About the Author
Dr. Michael Fu is an orthopedic surgeon and shoulder specialist at the Hospital for Special Surgery (HSS) in New York City (NYC) and New Jersey (NJ), the best hospital for orthopedics as ranked by U.S. News & World Report. Dr. Fu is an expert at shoulder rotator cuff repair surgery, shoulder instability surgery, and shoulder replacement. Dr. Fu was educated at Columbia University and Yale School of Medicine, followed by orthopedic surgery residency at HSS and sports medicine & shoulder surgery fellowship at Rush University Medical Center in Chicago. He has been a team physician for the Chicago Bulls, Chicago White Sox, DePaul University, and NYC’s PSAL.
Disclaimer: All materials presented on this website are the opinions of Dr. Michael Fu and any guest writers, and should not be construed as medical advice. Each patient’s specific condition is different, and a comprehensive medical assessment requires a full medical history, physical exam, and review of diagnostic imaging. If you would like to seek the opinion of Dr. Michael Fu for your specific case, we recommend contacting our office to make an appointment.