Question 1

Does every rotator cuff tear need surgery?

Accepted Answer

Most full-thickness rotator cuff tears do require surgery. Selected partial tears can sometimes be observed and treated conservatively. Nonsurgical treatment may also be appropriate for older patients or those with limited functional goals.

Question 2

What happens if I wait to repair a rotator cuff tear?

Accepted Answer

Rotator cuff tears can enlarge over time, with increasing tendon retraction, muscle atrophy, and deterioration in tendon quality. This can make the tear more difficult or eventually impossible to repair. Essentially, the sooner a repairable tear is treated, the better.

Question 3

Can a rotator cuff tear heal on its own?

Accepted Answer

A full-thickness rotator cuff tear will not heal back to the bone on its own. Symptoms may calm down with conservative treatment, but often not indefinitely.

Question 4

How do you determine whether my rotator cuff tear is repairable?

Accepted Answer

An MRI is necessary to determine whether a rotator cuff tear is repairable. Repairability is based on the size of the tear, condition of the joint, quality of the tendon, and the presence and degree of muscle atrophy.

Question 5

When is a rotator cuff patch used?

Accepted Answer

I generally use a rotator cuff patch in selected situations, including a partial rotator cuff tear that does not require a full repair, or to augment a large rotator cuff repair, particularly when the tendon tissue is thin or atrophic.

Question 6

Can rotator cuff tears be treated with cortisone injections?

Accepted Answer

Yes. One, and sometimes two, cortisone injections can be appropriate to help control symptoms. In general, I prefer to keep injections limited when a rotator cuff repair is being considered because repeated cortisone exposure can adversely affect tendon quality and may increase the risk of failure after rotator cuff repair.

Rotator Cuff Tear