Rotator Cuff Repair in Turkey: Indications, Procedure & Recovery

What is a rotator cuff repair?

A rotator cuff repair is a surgical procedure that reattaches one or more torn tendons to their original insertion point on the humerus, or upper arm bone. This is usually done using sutures and small fixation devices called anchors. This procedure is most often done arthroscopically, which uses a camera and specialized instruments inserted through small incisions. This method is used when the nature of the tear allows it.

Also known as rotator cuff surgery or tendon repair, this procedure may involve any of the four rotator cuff tendons. The supraspinatus tendon is most frequently affected.

What does the rotator cuff do, and how does it tear?

A rotator cuff tear can result from a sudden injury or from gradual wear of the tendons. To understand its consequences and the repair options, it helps to look at the role of the four tendons, how tears occur and the characteristics of each type of injury.

A role in mobility and stability

The rotator cuff is made up of four muscles and their tendons: the supraspinatus, infraspinatus, subscapularis and teres minor. Together, they allow the arm to rotate, help raise it and keep the head of the humerus centred in the joint. They therefore play an essential role in shoulder mobility and stability.

Causes: injury or wear

A rotator cuff tear can occur in two main ways:

• Traumatic tear: it follows a sudden event, such as a fall onto the arm, a sudden strain or a shoulder dislocation. It can affect a previously healthy tendon, but also one already weakened by pre-existing wear.
• Degenerative tear: it results from the gradual deterioration of the tendons, favoured in particular by ageing. Certain factors, such as repeated overhead arm movements, can also contribute to this wear. The tear may progress slowly and cause few symptoms for a long time.

The different types of tears

Please note: the size of a tear and whether it is irreparable are not the same thing. Some massive tears can still be repaired. Whether repair is possible depends in particular on the degree of retraction, the quality of the tendon, muscle atrophy and fatty infiltration of the muscle.

Symptoms and Diagnostic Tests

A rotator cuff tear can cause shoulder pain, often worse at night or during certain movements, along with reduced strength and difficulty lifting or rotating the arm. The pain may also radiate to the upper arm. Some tears, however, cause few symptoms and are discovered during an examination carried out for another reason.

Diagnosis relies on several elements, not all of which are necessarily needed:

• Clinical examination: mobility, strength and specific tests.
• X-ray: looks for arthritis or bone abnormalities, and sometimes for indirect signs of an old tear.
• Ultrasound: shows the tendons and certain tears.
• MRI: shows the size of the tear, retraction, and muscle atrophy and fatty infiltration, which are key factors in deciding whether to repair.

Other tests may be requested depending on your general health before anaesthesia.

Does a Rotator Cuff Tear Always Need Surgery?

No. Some tears can be managed with physiotherapy, adapting activities and medical treatment. Surgery is considered according to the characteristics of the injury, the symptoms and the patient's functional needs.

What Criteria Guide the Decision to Operate?

The choice between conservative treatment and surgery rests on several factors:

• Type, size and location of the tear.
• Whether it is traumatic or degenerative, and how long it has been present.
• Tendon retraction, tissue quality and the condition of the muscle.
• Pain and loss of function.
• Physiological age and activity level.
• Response to conservative treatment.
• Your expectations and needs (work, sport, independence).

Traumatic tears with significant loss of function may justify an early surgical assessment. Conversely, the guidelines of the American Academy of Orthopaedic Surgeons (AAOS) have long advised against operating on a complete tear that causes no symptoms.

According to the AAOS guidelines published in 2025, moderate-level evidence indicates that, when the tendon heals, surgery gives better patient-reported and functional outcomes than non-operative management. This condition is important: everything depends on the tendon healing.

What If the Tear Is Irreparable?

When tendon retraction, tissue deterioration or muscle damage prevents a satisfactory anatomical repair, other options may be considered. Depending on the condition of the shoulder and the patient's functional needs, the surgeon may suggest a partial repair, a tendon transfer, a superior capsular reconstruction or, in some situations, a reverse shoulder replacement.

Do you already have an MRI or ultrasound of your shoulder? Turquie Santé can arrange for your scans and medical file to be sent to a partner orthopaedic surgeon to obtain an opinion on the treatment options and the feasibility of a repair.

How Is the Surgery Performed?

Rotator cuff repair involves reattaching the torn tendon or tendons to their bone insertion using sutures and anchors. The technique used and any additional procedures depend on the extent of the tear, the quality of the tissue and the surgeon's findings during the operation.

Surgical Techniques

Three main approaches can be used:

• Arthroscopic: the surgeon makes a few small incisions to insert a camera and fine instruments. This is the most common approach and allows the tendon to be repaired without opening the joint widely.
• Mini-open: it combines an arthroscopic exploration with a limited incision that gives direct access to the tendon.
• Open: it requires a larger incision and may be considered in certain specific situations.

The choice depends on the injury, the quality of the tissue and the surgeon's experience. No technique is superior in every case.

How Is the Tendon Fixed to the Bone?

The surgeon generally uses suture anchors: small implants fixed in the bone and fitted with strong threads. These threads bring the tendon back to its bone footprint and hold it in place while it heals.

Depending on the configuration of the tear, the repair may be single-row, with one line of anchors, or double-row, with two lines of fixation. The choice of construct depends in particular on the size of the tear, the quality of the tendon and the fixation options available.

Additional and Biological Procedures

In some cases, the surgeon may combine other procedures (for example on the biceps tendon) or use biological augmentation. The 2025 AAOS guidelines include a strong recommendation for bioinductive implants during repair to reduce the risk of re-tear and improve patient-reported outcomes. They also state that many small to medium tears heal well without augmentation. It is therefore not a routine procedure.

Duration and Anaesthesia

The operation is generally performed under general anaesthesia, often combined with a nerve block to limit pain. Its duration varies according to complexity.

The hospital stay is generally short, with discharge on the same day or after one night, depending on the patient's condition and the facility's practices.

Risks and Complications

The usual aftermath of rotator cuff surgery includes postoperative pain, localised swelling, bruising and difficulty sleeping during the first few weeks.

Possible complications:

• Shoulder stiffness and temporarily limited range of motion.
• Surgical site infection requiring medical or surgical treatment.
• Haematoma formation or skin healing problems.
• Nerve or vascular injury, although this is rare.
• Failure of the tendon to heal or reattach to the bone.
• Risk of a new tear some time after the operation.
• A functional result the patient finds disappointing despite an initially satisfactory anatomical repair.

These risks depend on your general health, whether you smoke, whether you have diabetes, the size of the injury and how closely you follow the protocol. Your surgeon should explain them in detail before you decide.

Recovery After Rotator Cuff Repair

Recovery is gradual and may take several months. It depends on the size of the tear, the number of tendons repaired, the quality of the tissue and your surgeon's instructions. There is no universal timeline.

How Long Do You Need to Wear the Sling or Brace?

After surgery, the arm is generally held in a sling or brace, sometimes with an abduction pillow, to protect the repair during the first few weeks.

How long the arm is immobilised and when movement can begin vary according to the extent of the tear, the strength of the repair and the surgeon's practice.

For small to medium complete tears, the 2025 AAOS guidelines indicate, with a high level of evidence, that early mobilisation and mobilisation delayed for up to eight weeks can give comparable results. However, this does not automatically apply to every repair.

It is therefore important to follow your surgeon's instructions and not start certain movements without their approval.

The Main Stages of Rehabilitation

Rehabilitation generally follows several phases:

1. Protecting the repair and managing pain.
2. Passive mobilisation, guided by the protocol.
3. Gradual active mobilisation.
4. Muscle strengthening once healing allows.
5. Gradual return to daily, work and sporting activities.

Rehabilitation is part of the treatment. The tendon needs time to heal biologically, even when the pain subsides quickly.

Returning to Work

The time before returning to work depends mainly on the demands of the job and on how your recovery is progressing. An office job, where the arm position can be adjusted, can generally be resumed sooner than a physical job involving heavy lifting, repetitive movements or overhead work.

The surgeon decides with the patient when to go back to work, taking into account healing and job requirements.

Planning to have surgery in Turkey? Turquie Santé can help you arrange continuity of your medical follow-up and rehabilitation once you are back in your home country.

Results: Can a Repaired Rotator Cuff Tear Again?

Results develop over the months and vary according to the extent of the tear, the initial condition of the tendons and muscles, and the quality of healing and of rehabilitation.

What Benefits Can You Expect From the Surgery?

The expected benefits are less pain, better mobility, gradual recovery of strength and greater ease in everyday movements.

It is important to distinguish between two aspects:

• Anatomical healing: the repaired tendon adheres properly to its bone insertion.
• Functional recovery: improvement in pain, mobility, strength and everyday use of the shoulder.

These two outcomes do not always coincide. A tendon may fail to heal without causing significant symptoms. Conversely, an anatomically successful repair does not guarantee complete pain relief or a return to all previous abilities.

Can the Tendon Tear Again After Surgery?

Yes. A new tear is possible, even after a well-performed operation. The risk depends in particular on the size of the original injury, the quality of the tissue, the condition of the muscle, age and adherence to rehabilitation.

Alternatives to Rotator Cuff Repair

These options address different indications and are not interchangeable:

Repair is therefore not the best option for everyone. The right option is the one an orthopaedic surgeon confirms after examining you.

How Does Turquie Santé Support You?

Turquie Santé does not make diagnoses and does not decide whether surgery is indicated. These decisions belong to the surgeon.

Our support includes:

• Review of your medical file and imaging.
• Arranging an opinion from a partner orthopaedic surgeon.
• Coordination of the consultation, preoperative tests and surgery.
• Translation of your medical documents and interpreter assistance during your stay.
• Organisation of transfers and accommodation.
• Coordination of medical follow-up after you return home.

Would you like to know your shoulder treatment options in Turkey? Request a medical opinion based on your file.