Can a rotator cuff tear be treated without surgery?

Non-surgical treatment such as rest, medication, physiotherapy and injections may relieve symptoms, and surgery is considered if pain does not improve.

How soon should a rotator cuff tear from a fall be repaired?

There is no fixed timeline for surgery. However, traumatic rotator cuff tears, particularly full-thickness tears, may deteriorate over time. Early consultation with an orthopaedic specialist is recommended to assess the injury and determine the appropriate treatment.

Is rotator cuff tear repair done as day surgery?

Rotator cuff tear repair is typically done as day surgery. After the repair, patients are monitored in the recovery room and discharged home on the same day of surgery.

How long is the sling worn after rotator cuff repair?

The sling supports the shoulder and protects the repair while it heals. The recommended duration is 4-6 weeks and may vary depending on the repair and the patient's recovery.

When can I drive, work and play sports after shoulder tendon repair surgery?

Recovery varies from patient to patient. Strenuous activities and heavy lifting should be avoided for the first 3 months. Light activities, such as writing and typing, can generally resume immediately or within a few days, depending on discomfort.

What happens if a torn rotator cuff is not repaired?

A rotator cuff tear can enlarge over time, with the tendon retracting and the muscle developing fatty atrophy. This can make repair more difficult or impossible. The shoulder may lose stability, causing the humerus to migrate upwards and potentially leading to arthritis. Patients may also develop weakness and become unable to lift the arm fully, a condition known as pseudoparalysis.

Is rotator cuff repair covered by insurance or MediSave?

The clinic accepts claims under MediShield Life, Integrated Shield Plans, personal accident insurance and corporate insurance, and can help with enquiries about insurance claims. MediSave can be used for rotator cuff repair.

Rotator Cuff Tear Repair Surgery

Rotator cuff tear repair is surgery that reattaches a torn shoulder tendon to the bone, usually by keyhole (arthroscopic) surgery. It is considered for complete tears, tears from an injury, and tears that have not improved with non-surgical treatment. Dr. Poh Keng Soon, orthopaedic surgeon, consults and performs arthroscopic rotator cuff repair at Gleneagles Hospital and Mount Alvernia Hospital, as well as at any private hospital or day surgery centre in Singapore.

Who Needs Rotator Cuff Tear Repair?

Repair surgery is considered for some types of rotator cuff tears:

Acute traumatic tears: Tears caused by a sudden injury, such as a fall, may require early assessment and repair.
Symptomatic full-thickness tears: Surgery may be considered when a tear extends through the tendon and causes persistent pain or weakness.
Partial tears: Repair may be considered if partial tears do not improve with physiotherapy, activity modification, pain control and injections.

Dr Poh may recommend rotator cuff tear repair surgery for tears that do not improve with non-surgical treatment.

How Arthroscopic Rotator Cuff Tear Repair Is Done

For cases of rotator cuff tears that are severe or fail to respond to conservative treatments, surgical intervention may be necessary to restore function of the shoulder and alleviate symptoms. Rotator cuff repair surgery is a common procedure aimed at reattaching the torn tendon to its original position on the humerus bone and promoting healing.

Anaesthesia: Rotator cuff repair is usually done under general anaesthesia, sometimes with a regional nerve block for pain control.
Arthroscopic Assessment: The orthopaedic surgeon makes a small stab incision to access the shoulder joint and inserts an arthroscope, a small camera, to assess the tear's size, location and the condition of the surrounding tissues.
Tendon and Bone Preparation: Once the tear is identified, the surgeon prepares the bone surface for tendon re-attachment. Microfracture may also be performed to stimulate stem cell release and promote biological healing.
Tendon Reattachment: Sutures or anchors are used to reattach the tendon to its original insertion point on the humerus. Depending on the tear’s characteristics and severity, the surgeon may use single-row or double-row fixation. A collagen patch or brace may sometimes be used to augment the repair and support healing, particularly for larger, chronic or recurrent tears.
Wound Closure and Recovery: Once the repair is complete, the incisions are closed and a sterile dressing is applied. Patients are typically monitored in the recovery room before being discharged home on the same day.

Recovery and Rehabilitation After Rotator Cuff Tear Repair

Following rotator cuff tear repair surgery, a structured rehabilitation program is essential for optimising outcomes and preventing complications. This may involve:

Sling Support: Initially, a protective sling is worn for 4-6 weeks after surgery to support the shoulder and promote tendon healing.
Physical Therapy: Gentle movement of the elbow, forearm, wrist, hand and fingers begins immediately after surgery. Light activities using the operated arm, such as writing, typing, eating and brushing teeth, can generally resume immediately or within a few days, depending on discomfort.
Activity Modification: Patients are advised to avoid strenuous activities and heavy lifting during the initial stages of recovery for 3 months after surgery.

The recovery timeline after rotator cuff repair surgery varies depending on the size of the tear, the quality of the repaired tissue, and the patient's health and fitness.

Are All Rotator Cuff Tears Repairable?

While most rotator cuff tears are amenable to surgical repair, certain cases may be deemed irreparable due to factors such as chronicity, tissue quality, and tear size. In such instances, alternative surgical options like tendon transfers, superior capsular reconstruction (SCR) with tissue graft, balloon spacer or reverse shoulder replacement may be considered to alleviate symptoms and restore shoulder function. Your orthopaedic surgeons will evaluate each case individually, weighing the risks and benefits of various treatment approaches.

Risks of Rotator Cuff Repair Surgery

The risks of rotator cuff repair surgery include:

The tendon not healing, or tearing again
Stiffness
Infection
Nerve injury
Pain or weakness that continues

These risks will be explained and discussed in detail at the consultation.

Rotator Cuff Tear Repair Surgeon in Singapore: Dr. Poh Keng Soon

Dr Poh Keng Soon I Orthopaedic Surgeon I Shoulder Elbow Specialist

Dr. Poh Keng Soon is registered with the Singapore Medical Council as an orthopaedic specialist and completed subspecialty fellowship training in sports, shoulder and elbow surgery in Melbourne, Australia, under a Ministry of Health Health Manpower Development Plan (HMDP) award. He performs arthroscopic rotator cuff repair and shoulder replacement for rotator cuff tears that cannot be repaired.

Qualifications & Professional Appointments

Medical Qualifications: MRCS (Edinburgh, 2013), Master of Medicine (MMed) in Orthopaedic Surgery from the National University of Singapore (2017) and FRCS (Edinburgh, 2018).
Clinical & Academic Appointments: Visiting Consultant at National University Hospital and Adjunct Assistant Professor at the NUS Yong Loo Lin School of Medicine.
Subspecialty Fellowship: Completed sports, shoulder and elbow surgery training in Melbourne, Australia, under a Ministry of Health Health Manpower Development Plan (HMDP) award.
Hospital Accreditation: Accredited to perform surgery at Mount Elizabeth, Mount Elizabeth Novena, Gleneagles, Parkway East, Mount Alvernia and Farrer Park hospitals, as well as Thomson Medical Centre, Cura, Aptus and Novaptus Medical Centre.