Rotator cuff surgery is performed as an outpatient procedure, which means you come to the hospital and go home on the same day as the operation.  The procedure is done arthroscopically with a few small incisions (less than 1 cm) around the shoulder region.  Regional anesthesia is utilized, which involves freezing the shoulder and intravenous sedation.  General anesthesia is not required.  The operation is done arthroscopically, which means that a camera is inserted into the shoulder through one of the small incisions, and instruments are used through other small incisions to perform the procedure.  If your rotator cuff is intact or not completely torn, the operation will consist of removing bursa (inflamed tissue in the shoulder) and subacromial decompression (removal of a bone spur).  If your rotator cuff is torn, it will be repaired to the bone using sutures.  A small metal screw is inserted into the bone, which has sutures attached to it.  The sutures will be passed through the rotator cuff tissue, and a knot will be tied that holds the rotator cuff down to the bone.  Over time, the rotator cuff will heal to the bone.  It takes at least 6 weeks for the rotator cuff to heal to the bone, so you are not allowed to lift your arm (or even try to lift your arm) for 6 weeks.  At 6 weeks, you can begin to lift your arm against gravity, but not lift any objects.  At 12 weeks, you can start lifting light objects with your operated arm.

If your rotator cuff is not torn, then the recovery is much quicker and you can start using the arm as soon as it is comfortable.  The use of a sling is generally recommended for 2 weeks.  If the rotator cuff is repaired, you must keep your arm in a sling for 6 weeks.  Physical therapy is continued for several months to allow you to regain motion and strength in the shoulder.  By 3-4 months, most people feel better than before the surgery and the improvement continues until 6 months after surgery.  At 6 months, patients are allowed to return to all activities.  Most patients continue to improve until 12 months after surgery. 

Risks of surgery include, but are not limited to, anesthesia, infection, re-operation, stiffness, re-tear of the cuff (if repaired), nerve or blood vessel injury and pain.