When rotator cuff tendons are torn and causing pain, inability to sleep, loss of shoulder function they need to be repaired to avoid permanent damage to the shoulder joint.
Prompt repair of the tendon ensures best results, reduces the chance of muscle wasting and retains the mobility of the tissues to fix it back in place. Repair of the tendons can be done by arthroscopic technique and I prefer this for small tears.
Large tears I prefer to do all the freeing up of the tendons by arthroscopy and do a reliable fixation by a double row repair using generally the speedbridge technique. I have had no clinical failures of the repair by this technique but success depends on the quality of the tendon and delay in referral /diagnosis.
In addition to repairing the rotator cuff, labral repairs and biceps tendon surgery (tenodesis) may be required. Recovery of function after this operation takes time and rehabilitation.