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Rotator cuff repair - double-row, done properly.

Arthroscopic double-row suture-bridge cuff repair with a fellowship-trained shoulder consultant. A structured six-month rehab plan handed to you before you leave theatre - and, when a tear is irreparable, an honest conversation about SCR, tendon transfer or reverse shoulder replacement.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private cuff repair costs in the UK.

Indicative ranges.

In short

£7,500–£11,500, home day-case.

ProcedureIndicative range
Arthroscopic single-tendon rotator cuff repair£7,500–£11,500
Arthroscopic massive/multi-tendon repair£10,000–£15,000
Repair with biceps tenodesis£9,000–£13,500
Superior capsular reconstruction (SCR)£12,000–£18,000
Revision cuff repair£11,000–£17,000
Consultant shoulder opinion£250–£400

Prices vary by hospital, consultant, anchor number and whether a biceps tenodesis or capsular reconstruction is added.

The problem

The repair is the easy bit - rehab is the operation.

Where general shoulder services under-deliver: no MRI review before booking, no proper rehab handover, and a doomed repair sold to a patient who needed a reverse.

  • MRI reviewed with a shoulder eye

    Fatty infiltration, retraction and subscapularis involvement - three things routinely under-called on general reports.

  • A six-month plan handed to you

    Written phase-by-phase physio protocol before you leave, and named physio contacts on day one.

  • The honest irreparable conversation

    When a repair will fail, we tell you. SCR, tendon transfer or reverse shoulder - chosen for the joint you have.

When it helps

When cuff repair is the right operation.

The situations we see most, plus the red flag that means the repair is likely to fail and reverse arthroplasty is the better answer.

  • Traumatic full-thickness tear in an active adult

    A recent tear after a fall or lifting injury, with sudden weakness in external rotation or elevation - repair sooner rather than later.

  • Degenerative tear with failed conservative treatment

    Six months of physio, injections and NSAIDs have not held - pain and weakness are limiting sleep and work.

  • Progressive tear on serial imaging

    A partial-thickness tear that has enlarged or a full-thickness tear that has retracted - earlier repair protects against irreparability.

  • Symptomatic tear in an overhead worker or athlete

    Painters, electricians, tennis and racket players - where cuff function is essential to the day-to-day.

  • Failed previous cuff repair

    A re-tear on repeat MRI with new pain and weakness - revision repair or a salvage option may be appropriate.

  • Symptomatic subscapularis tear

    Weak internal rotation, positive belly-press or bear-hug - often missed on general MRI reporting and worth a shoulder-specialist review.

  • Cuff tear with concurrent biceps or labral pathology

    A long-head-of-biceps tear or SLAP lesion alongside cuff disease - addressed at the same sitting.

  • Red flag: fatty infiltration Goutallier 3–4

    A large retracted tear with advanced muscle fatty change is often irreparable - reverse shoulder replacement usually beats a doomed repair. We say so.

Procedure options

The right technique for the tear you have.

Every repair variant plus the salvage options for irreparable disease.

  • Arthroscopic double-row suture-bridge repair

    The modern UK standard for repairable tears - medial mattress row, lateral compression anchors, footprint restoration.

  • Single-row repair

    Reserved for small tears, thin tissue or elderly patients where anchor density matters less. Still a valid technique in the right hands.

  • Repair with biceps tenodesis or tenotomy

    A degenerate long head of biceps is a common pain generator - addressed at the same sitting to protect the repair.

  • Repair with subacromial decompression

    Bone spurs are shaved back if they threaten the repair; routine acromioplasty for its own sake is no longer standard.

  • Superior capsular reconstruction (SCR)

    For irreparable posterosuperior tears in a well-preserved joint - a fascia lata or dermal allograft covers the humeral head.

  • Latissimus or lower trapezius tendon transfer

    For selected irreparable tears in younger patients where a reverse arthroplasty is too much operation too soon.

  • Reverse shoulder arthroplasty

    For irreparable tears with cuff-tear arthropathy or older patients - reliable pain relief and functional overhead motion.

  • Biological augmentation

    Dermal allograft patches or biological adjuncts in selected re-tears or poor-quality tissue - evidence still evolving.

Safety and recovery

What to expect afterwards - honestly.

Cuff repair is well established. The things worth planning are the block, the sling and - above all - the six-month rehab.

  • GA plus regional block

    An interscalene block gives 12–18 hours of pain relief and lets you go home comfortably. GA is light and you are extubated in theatre.

  • Re-tear risk depends on the tear

    Small tears re-tear in under 10 percent, large tears 20–30 percent, massive retracted tears higher still. Fatty infiltration is the biggest predictor.

  • Stiffness

    Postoperative stiffness affects 5–10 percent and usually loosens with time and physio. A minority need a manipulation.

  • Infection

    Deep infection under 1 percent. Prophylactic antibiotics, betadine skin prep and single-use drapes are standard.

  • Nerve issues

    Interscalene block can cause temporary phrenic nerve palsy - well-tolerated in healthy patients, planned for in COPD.

  • DVT and PE

    Uncommon after shoulder surgery. Encouraged mobilisation and calf pump exercises are enough for most.

  • Sling for four to six weeks

    Abduction-pillow sling protects the repair. No lifting, no driving, no lying on the side for six weeks.

  • Return to activity

    Desk work 1–3 weeks with the sling on, driving 6 weeks, gym and light sport 4 months, contact sport and overhead throwing 6–9 months.

  • Red flags after surgery

    Wound discharge, fever, spreading redness, sudden new severe pain or a hand that goes cold or numb: same-day team or A&E.

Reading your operation note

Your operation note in four parts. Read the last one first.

Arthroscopic notes are terse - anchors listed by name and number. We translate them for you.

A UK consultant shoulder surgeon reviewing arthroscopic images

A quiet reminder

Arthroscopic photos come with the note - ask for them.

If you would like us to walk you through the pictures and the plan before your six-week review, just ask.

  1. 01Header

    Tear pattern and anchors used

    Which tendons torn, tear size and retraction, anchor number and configuration (single or double-row).

  2. 02Technique

    Portals and adjuncts

    Portal placement, subacromial decompression yes or no, biceps tenodesis or tenotomy, and any concurrent labral work.

  3. 03Findings

    Tissue quality and coverage

    Fatty infiltration grade, tendon quality, whether full footprint coverage was achieved and any gap in restoration.

  4. 04Impression

    Sling, physio and return

    Read this first: sling weeks, phase-by-phase physio, review dates and expected return to work and sport.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cuff repair is usually covered by UK insurers after pre-authorisation.

Frequently asked

Everything we get asked about cuff repair.

Quick answers on double-row technique, rehab, cost and irreparable-tear options.

  • When should a rotator cuff tear be repaired rather than watched?

    Traumatic tears in active adults are usually repaired within three to six months to protect against retraction and fatty infiltration. Degenerative tears may respond to six months of structured physio and injection; if pain and weakness persist, or the tear enlarges on serial imaging, surgery is offered. Irreparable, fatty-infiltrated tears in older patients are often better served by reverse shoulder replacement.

  • What is a double-row suture-bridge repair?

    Two rows of anchors reconstruct the tendon-to-bone footprint. A medial row of mattress sutures reduces the tendon to bone, and a lateral compression row bridges the sutures over the tendon and anchors them to the lateral humerus. It restores the anatomic footprint better than single-row and is the modern UK standard for repairable tears.

  • How long is recovery after arthroscopic cuff repair?

    The sling is worn for four to six weeks. Passive range starts week one, active-assisted at six weeks, strength at twelve weeks. Desk work in the sling at one to three weeks, driving at six weeks, gym and light sport by four months, overhead throwing and contact sport at six to nine months.

  • How much does private rotator cuff repair cost in the UK?

    Roughly £7,500–£11,500 for an arthroscopic single-tendon repair, £10,000–£15,000 for a massive or multi-tendon repair, £9,000–£13,500 with a biceps tenodesis, £12,000–£18,000 for superior capsular reconstruction and £11,000–£17,000 for revision surgery. Most UK insurers cover it after pre-authorisation.

  • What happens if my tear cannot be repaired?

    Options include a partial repair, superior capsular reconstruction, latissimus or lower trapezius tendon transfer, or reverse shoulder arthroplasty. The right choice depends on age, activity, muscle quality and whether arthritis is already present. Do not accept a doomed repair - a good surgeon tells you when to skip it.

  • Do I have to do six months of physio? What if I do not?

    Yes. The tendon-to-bone healing takes at least three months, and the strength phase runs into month six. Skipping the protocol is the fastest route to a re-tear. A good repair with poor rehab is worse than a well-rehabbed non-operative shoulder.

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